Whole lung lavage (WLL), also called lung washing, is a medical procedure in which the patient's lungs are washed with
saline (salt water) by filling and draining repeatedly. It is used to treat
pulmonary alveolar proteinosis, in which excess lung surfactant proteins prevent the patient from breathing.[1][2] Some sources consider it a variation of
bronchoalveolar lavage.[3]
WLL has been experimentally used for
silicosis,[4] other forms of mineral inhalation, and accidental inhalation of radioactive dust.[5] It appears to effectively remove these foreign particles.[4][6] WLL treatments may slow down the lung function decline of miners with
pneumoconiosis.[7]
Medical uses
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Procedure and technique
WLL is not a standarized procedure. Patients are usually first put under
general anesthesia. A double lumen endotracheal tube is used to keep one lung breathing while the other is being washed. The lung to be washed is filled with fluid by gravity, then drained. Drainage can be done by suction[2] or gravity.[8] Some versions add a shaking step between the filling and draining to help with the washing.[2] The procedure typically uses 10–20 liters of fluid per patient, but severe cases require up to 50.[2]
Variations on the WLL include a "mini-WLL" with reduced infusion volume.[9] Reducing the suction power seems to reduce lung injury.[10]
Solutions
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Devices
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Adverse effects
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Mechanism of action
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History
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^Zeng Y, Jiang Y, Banks DE (August 2022). "The Effectiveness of Whole Lung Lavage in Pneumoconiosis: A Systematic Review and Meta-Analysis". J Occup Environ Med. 64 (8): e492–e499.
doi:
10.1097/JOM.0000000000002599.
PMID35732044.
S2CID249956633.