99:
184:
353:
drops per minute. This process was repeated four times a day for 2–3 weeks. This technique showed improvement in chest-X-ray, diffusion capacity and histo-pathological findings. It was a prolonged and distressing procedure. The technique was thought to be imperfect and therefore denounced by many physicians at that time. In 1964, Ramirez-Rivera used a double lumen endotracheal tube (DLT) to isolate each lung, instilling up to 3 L saline containing
172:. 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 or gravity. Some versions add a shaking step between the filling and draining to help with the washing. The procedure typically uses 10–20 liters of fluid per patient, but severe cases require up to 50.
255:
140:, whole lung lavage has been explored as a treatment method, especially in experimental models. Studies have shown that WLL can be used to deplete surfactant, followed by the administration of surfactant replacement therapies. This approach helps improve lung function and oxygenation in conditions like neonatal
352:
In 1963, Dr. Jose
Ramirez-Rivera at the Veterans’ Administration Hospital in Baltimore tried repeated instillation of normal saline by a transtracheal plastic catheter positioned in one lung at a time in a series of two patients. Aliquots of 100 mL of warmed saline were instilled at a rate of 50–60
269:
Whole lung lavage (WLL) is a relatively safe procedure when performed by experienced medical teams, but it carries some risks and potential adverse effects. Here are the main complications and adverse effects associated with WLL. During the procedure, one lung is ventilated while the other is being
343:
The removal of excess material from the alveoli improves lung compliance (the ability of the lungs to expand and contract). This leads to more effective ventilation and better oxygenation of the blood. Patients often experience a significant improvement in symptoms such as shortness of breath
361:. This trial provided evidence that such a procedure was safe and feasible. Over the next four decades, the procedure has been further refined using general anesthesia, increased lavage volumes use of saline alone and by performing bilateral sequential WLL in the same treatment session
334:
removal, WLL can help reduce the concentration of inflammatory mediators within the alveoli. This can be particularly beneficial in conditions involving lung inflammation, as it helps to alleviate the inflammatory response and promote healing of the lung tissue.
889:
Mariani, Francesca; Salvaterra, Elena; Lettieri, Sara; De
Silvestri, Annalisa; Corino, Alessandra; Bosio, Matteo; Fraolini, Elia; Piloni, Davide; Rodi, Giuseppe; Corsico, Angelo Guido; Campo, Ilaria (December 2022).
250:
has two separate lumens for independent lung ventilation and lavage.It ensures that the patient maintains adequate oxygenation during the procedure, as one lung remains functional while the other is being washed
86:, other forms of mineral inhalation, and accidental inhalation of radioactive dust. It appears to effectively remove these foreign particles. WLL treatments may slow down the lung function decline of miners with
322:, WLL restores the normal architecture of the alveoli. This improves their ability to facilitate gas exchange, leading to better oxygenation of the blood and overall respiratory function
1174:
781:
Hilgendorff, Anne; Aslan, Ece; Schaible, Thomas; Gortner, Ludwig; Baehner, Thorsten; Ebsen, Michael; Kreuder, Jochen; Ruppert, Clemens; Guenther, Andreas; Reiss, Irwin (2008-07-14).
473:
223:(collapse of lung tissue). The total volume of saline used can vary but typically ranges from 15 to 20 liters per lung, administered in aliquots of 500 to 1000 ml.
1167:
128:, where it helps remove accumulated surfactant proteins from the lungs. However, its application extends to other respiratory conditions, including
37:
1788:
1160:
380:
672:
Zeng Y, Jiang Y, Banks DE (August 2022). "The
Effectiveness of Whole Lung Lavage in Pneumoconiosis: A Systematic Review and Meta-Analysis".
840:
Shrestha, D; Dhooria, S; Munirathinam, GK; Sehgal, IS; Prasad, KT; Ram, B; Singh, H; Aggarwal, AN; Puri, GD; Muthu, V; Agarwal, R (2022).
1524:
157:
149:
145:
141:
137:
133:
129:
302:
accumulate in the alveoli, impairing gas exchange and leading to respiratory insufficiency. WLL works by instilling large volumes of
783:"Surfactant replacement and open lung concept – Comparison of two treatment strategies in an experimental model of neonatal ARDS"
175:
Variations on the WLL include a "mini-WLL" with reduced infusion volume. Reducing the suction power seems to reduce lung injury.
1783:
258:
247:
243:
239:
1302:
125:
121:
108:
72:
1718:
1693:
481:
943:"Lung injury induced by different negative suction pressure in patients with pneumoconiosis undergoing whole lung lavage"
1688:
1334:
941:
Yang, Mingyuan; Li, Baoping; Wang, Bin; Li, Lei; Ji, Yurong; Zhou, Yunzhi; Huang, Rui; Cheng, Qinghao (December 2022).
75:, in which excess lung surfactant proteins prevent the patient from breathing. Some sources consider it a variation of
306:
into the lung, which helps to dissolve and mobilize these accumulated materials. The saline, along with the dissolved
1678:
1534:
1529:
1097:
Galhenage, Janith; Weerasinghe, Buddhika; Dilesha, Wadasinghe; Constantine, Roshana; Gunasena, Bandu (2017-03-08).
98:
1396:
278:
is a common but usually manageable complication, and oxygen levels are closely monitored throughout the procedure
1758:
1585:
1552:
1544:
1312:
1201:
246:) is used to isolate each lung. This allows one lung to be ventilated while the other lung is lavaged. The
1748:
1713:
1683:
1618:
1519:
153:
76:
1728:
1391:
1152:
183:
152:
treatment strategies. The primary goal in these scenarios is to understand how surfactant therapy and
1600:
1575:
1386:
1723:
1705:
1673:
1623:
1248:
1099:"Pulmonary alveolar proteinosis and first successful whole lung lavage in Sri Lanka: a case report"
275:
430:
Michaud, G.; Reddy, C.; Ernst, A. (2009). "Whole-lung lavage for pulmonary alveolar proteinosis".
1595:
1567:
1421:
1321:
1184:
697:
605:
556:
169:
1753:
1743:
1256:
1138:
1120:
1079:
1038:
1020:
974:
923:
871:
822:
804:
763:
745:
689:
654:
597:
512:
447:
303:
212:
200:
192:
68:
32:
1128:
1110:
1069:
1028:
1010:
964:
954:
913:
903:
861:
853:
812:
794:
753:
735:
681:
644:
636:
587:
546:
439:
1058:"Whole lung lavage in pulmonary alveolar proteinosis: anesthetic management and challenges"
1506:
1478:
1381:
649:
624:
1665:
1644:
1628:
1485:
1434:
1329:
1243:
1133:
1098:
1033:
998:
969:
942:
918:
891:
866:
841:
817:
782:
758:
723:
405:
358:
87:
551:
534:
1777:
1514:
1442:
1406:
1371:
701:
208:
560:
1610:
1452:
1355:
1285:
1280:
892:"A mini-whole lung lavage to treat autoimmune pulmonary alveolar proteinosis (PAP)"
609:
400:
999:"Whole lung lavage—technical details, challenges and management of complications"
724:"Whole lung lavage—technical details, challenges and management of complications"
685:
592:
575:
1590:
1470:
1457:
1447:
1415:
1339:
1290:
1228:
1223:
1218:
535:"P112 Therapeutic Whole Lung Lavage For Silicosis – First Application in the UK"
504:
395:
220:
1074:
1057:
959:
908:
857:
1580:
1462:
1363:
1264:
1238:
1233:
1210:
1115:
370:
331:
319:
307:
292:
227:
204:
196:
103:
1124:
1083:
1024:
808:
749:
1738:
1376:
1295:
1015:
740:
410:
271:
83:
46:
1142:
1042:
978:
927:
875:
826:
799:
767:
693:
658:
640:
625:"Impact of Whole Lung Lavage on Pneumoconiosis Patients - China, 2018-2022"
516:
451:
310:, is then drained from the lung, effectively clearing the alveolar spaces.
211:
material deposited in the alveoli, facilitating its removal from the lungs.
601:
443:
168:
WLL is not a standardized procedure. Patients are usually first put under
1347:
385:
112:.The images show the characteristic airspace filling with focally dense
1557:
1192:
354:
295:
230:
may be administered to help restore normal lung function after lavage.
224:
120:
Whole lung lavage (WLL) is primarily used for treating conditions like
113:
67:, is a medical procedure in which the patient's lungs are washed with
1733:
1430:
1410:
1272:
390:
375:
216:
71:(salt water) by filling and draining repeatedly. It is used to treat
254:
997:
Awab, Ahmed; Khan, Muhammad S.; Youness, Houssein A. (June 2017).
722:
Awab, Ahmed; Khan, Muhammad S.; Youness, Houssein A. (June 2017).
299:
97:
533:
Prudon, B; Attanoos, R; Morgan, C; Stenton, Sc (December 2012).
1156:
574:
Danel, C.; Israël-Biet, D.; Costabel, U.; Klech, H. (1992).
199:
of body fluids, making it gentle on the lung tissues. The
503:
Patel, Pujan H.; Antoine, Marsha H.; Ullah, Saad (2023).
215:
instillation helps maintain lung expansion during the
623:
Chen, Y; Lyu, X; Li, T; Wang, H (22 September 2023).
576:"Therapeutic applications of bronchoalveolar lavage"
148:
but is used in research settings to model and study
1704:
1664:
1657:
1637:
1609:
1566:
1543:
1505:
1498:
1405:
1311:
1200:
1191:
270:lavaged, which can temporarily reduce oxygenation.
31:
23:
18:
846:Sarcoidosis, Vasculitis, and Diffuse Lung Diseases
1056:Manohar, Manisha; Bansal, Priyanka (2022-02-05).
318:By physically washing out the debris and excess
203:serves several purposes. It helps dissolve the
191:The primary solution used in WLL is a sterile,
339:Improvement of Lung Compliance and Oxygenation
1168:
467:
465:
463:
461:
8:
528:
526:
474:"How 'Lung Washing' Helps You Breathe Again"
195:solution. This solution closely matches the
1661:
1502:
1197:
1175:
1161:
1153:
1132:
1114:
1073:
1032:
1014:
968:
958:
917:
907:
865:
816:
798:
757:
739:
648:
591:
550:
253:
182:
422:
15:
992:
990:
988:
381:Chronic obstructive pulmonary disease
156:strategies can be optimized to treat
144:.WLL is not a standard treatment for
82:WLL has been experimentally used for
7:
1062:Ain-Shams Journal of Anaesthesiology
717:
715:
713:
711:
1525:High-resolution computed tomography
1183:Tests and procedures involving the
326:Reduction of Inflammatory Mediators
130:Acute Respiratory Distress Syndrome
42:
472:Cleveland Clinic (6 August 2014).
14:
842:"How We Do It: Whole Lung Lavage"
552:10.1136/thoraxjnl-2012-202678.395
287:Removal of Accumulated Surfactant
314:Restoration of Alveolar Function
1103:Journal of Medical Case Reports
259:Double-lumen endobronchial tube
1303:Laryngotracheal reconstruction
240:double-lumen endotracheal tube
122:pulmonary alveolar proteinosis
109:pulmonary alveolar proteinosis
73:pulmonary alveolar proteinosis
1:
1789:Respiratory system procedures
1694:Positive pressure ventilation
1689:Negative pressure ventilator
686:10.1097/JOM.0000000000002599
593:10.1183/09031936.93.05101173
580:European Respiratory Journal
1003:Journal of Thoracic Disease
728:Journal of Thoracic Disease
1805:
1679:Surgical airway management
1535:Ventilation/perfusion scan
1335:Tracheoesophageal puncture
1075:10.1186/s42077-022-00213-6
960:10.1186/s12890-022-01952-w
909:10.1186/s12931-022-01982-2
858:10.36141/svdld.v39i2.12884
1116:10.1186/s13256-017-1218-2
511:. StatPearls Publishing.
43:
1759:Pulmonary rehabilitation
1586:Bronchial challenge test
1553:Pneumonia severity index
1545:Clinical prediction rule
545:(Suppl 2): A111.1–A111.
505:"Bronchoalveolar Lavage"
1016:10.21037/jtd.2017.04.10
741:10.21037/jtd.2017.04.10
164:Procedure and technique
1784:Diagnostic pulmonology
1749:Hyperinflation therapy
1714:Artificial respiration
1684:Mechanical ventilation
1619:Bronchoalveolar lavage
1520:CT pulmonary angiogram
947:BMC Pulmonary Medicine
800:10.1186/1471-2466-8-10
787:BMC Pulmonary Medicine
641:10.46234/ccdcw2023.160
261:
188:
154:mechanical ventilation
117:
77:bronchoalveolar lavage
1729:Decompression chamber
1397:Heart–lung transplant
444:10.1378/chest.09-2295
257:
186:
101:
1601:Impulse oscillometry
1576:Body plethysmography
896:Respiratory Research
219:process, preventing
136:).In the context of
1724:Hyperbaric medicine
1706:Respiratory therapy
1624:Nasopharyngeal swab
1249:Acoustic rhinometry
674:J Occup Environ Med
282:Mechanism of action
102:High magnification
1596:Diffusion capacity
1568:Lung function test
1185:respiratory system
262:
189:
170:general anesthesia
160:more effectively.
118:
1771:
1770:
1767:
1766:
1754:Pulmonary hygiene
1744:Postural drainage
1653:
1652:
1494:
1493:
484:on 14 August 2020
57:Whole lung lavage
54:
53:
19:Whole lung lavage
1796:
1662:
1658:Other procedures
1503:
1198:
1177:
1170:
1163:
1154:
1147:
1146:
1136:
1118:
1094:
1088:
1087:
1077:
1053:
1047:
1046:
1036:
1018:
1009:(6): 1697–1706.
994:
983:
982:
972:
962:
938:
932:
931:
921:
911:
886:
880:
879:
869:
837:
831:
830:
820:
802:
778:
772:
771:
761:
743:
734:(6): 1697–1706.
719:
706:
705:
680:(8): e492–e499.
669:
663:
662:
652:
629:China CDC Weekly
620:
614:
613:
595:
571:
565:
564:
554:
530:
521:
520:
500:
494:
493:
491:
489:
480:. Archived from
478:HealthEssentials
469:
456:
455:
438:(6): 1678–1681.
427:
47:edit on Wikidata
16:
1804:
1803:
1799:
1798:
1797:
1795:
1794:
1793:
1774:
1773:
1772:
1763:
1700:
1649:
1633:
1605:
1562:
1539:
1507:Medical imaging
1490:
1479:Mediastinoscopy
1419:
1414:
1401:
1387:Transplantation
1382:Wedge resection
1307:
1187:
1181:
1151:
1150:
1096:
1095:
1091:
1055:
1054:
1050:
996:
995:
986:
940:
939:
935:
888:
887:
883:
852:(2): e2022017.
839:
838:
834:
780:
779:
775:
721:
720:
709:
671:
670:
666:
635:(38): 844–848.
622:
621:
617:
573:
572:
568:
532:
531:
524:
502:
501:
497:
487:
485:
471:
470:
459:
429:
428:
424:
419:
367:
350:
330:In addition to
316:
289:
284:
267:
265:Adverse effects
236:
193:isotonic saline
187:Saline solution
181:
166:
96:
63:), also called
50:
12:
11:
5:
1802:
1800:
1792:
1791:
1786:
1776:
1775:
1769:
1768:
1765:
1764:
1762:
1761:
1756:
1751:
1746:
1741:
1736:
1731:
1726:
1721:
1716:
1710:
1708:
1702:
1701:
1699:
1698:
1697:
1696:
1691:
1681:
1676:
1670:
1668:
1666:Oxygen therapy
1659:
1655:
1654:
1651:
1650:
1648:
1647:
1645:Blood gas test
1641:
1639:
1635:
1634:
1632:
1631:
1629:Sputum culture
1626:
1621:
1615:
1613:
1607:
1606:
1604:
1603:
1598:
1593:
1588:
1583:
1578:
1572:
1570:
1564:
1563:
1561:
1560:
1555:
1549:
1547:
1541:
1540:
1538:
1537:
1532:
1527:
1522:
1517:
1511:
1509:
1500:
1496:
1495:
1492:
1491:
1489:
1488:
1486:Nuss procedure
1482:
1481:
1476:
1474:
1466:
1465:
1460:
1455:
1450:
1445:
1440:
1438:
1435:pleural cavity
1426:
1424:
1403:
1402:
1400:
1399:
1394:
1389:
1384:
1379:
1374:
1369:
1367:
1359:
1358:
1353:
1351:
1343:
1342:
1337:
1332:
1330:Cricothyrotomy
1327:
1325:
1317:
1315:
1309:
1308:
1306:
1305:
1300:
1299:
1298:
1288:
1283:
1278:
1276:
1268:
1267:
1262:
1260:
1252:
1251:
1246:
1244:Rhinomanometry
1241:
1236:
1231:
1226:
1221:
1216:
1214:
1206:
1204:
1195:
1189:
1188:
1182:
1180:
1179:
1172:
1165:
1157:
1149:
1148:
1089:
1048:
984:
933:
881:
832:
773:
707:
664:
615:
586:(10): 1173–5.
566:
522:
495:
457:
421:
420:
418:
415:
414:
413:
408:
406:Pneumoconiosis
403:
398:
393:
388:
383:
378:
373:
366:
363:
359:acetylcysteine
349:
346:
344:following WLL
315:
312:
288:
285:
283:
280:
266:
263:
235:
232:
180:
177:
165:
162:
95:
92:
88:pneumoconiosis
52:
51:
44:
41:
40:
35:
29:
28:
25:
21:
20:
13:
10:
9:
6:
4:
3:
2:
1801:
1790:
1787:
1785:
1782:
1781:
1779:
1760:
1757:
1755:
1752:
1750:
1747:
1745:
1742:
1740:
1737:
1735:
1732:
1730:
1727:
1725:
1722:
1720:
1717:
1715:
1712:
1711:
1709:
1707:
1703:
1695:
1692:
1690:
1687:
1686:
1685:
1682:
1680:
1677:
1675:
1672:
1671:
1669:
1667:
1663:
1660:
1656:
1646:
1643:
1642:
1640:
1636:
1630:
1627:
1625:
1622:
1620:
1617:
1616:
1614:
1612:
1608:
1602:
1599:
1597:
1594:
1592:
1589:
1587:
1584:
1582:
1579:
1577:
1574:
1573:
1571:
1569:
1565:
1559:
1556:
1554:
1551:
1550:
1548:
1546:
1542:
1536:
1533:
1531:
1528:
1526:
1523:
1521:
1518:
1516:
1515:Bronchography
1513:
1512:
1510:
1508:
1504:
1501:
1497:
1487:
1484:
1483:
1480:
1477:
1475:
1473:
1472:
1468:
1467:
1464:
1461:
1459:
1456:
1454:
1451:
1449:
1446:
1444:
1443:Thoracentesis
1441:
1439:
1437:
1436:
1432:
1428:
1427:
1425:
1423:
1417:
1412:
1408:
1404:
1398:
1395:
1393:
1392:Decortication
1390:
1388:
1385:
1383:
1380:
1378:
1375:
1373:
1372:Pneumonectomy
1370:
1368:
1366:
1365:
1361:
1360:
1357:
1354:
1352:
1350:
1349:
1345:
1344:
1341:
1338:
1336:
1333:
1331:
1328:
1326:
1324:
1323:
1319:
1318:
1316:
1314:
1310:
1304:
1301:
1297:
1294:
1293:
1292:
1289:
1287:
1284:
1282:
1279:
1277:
1275:
1274:
1270:
1269:
1266:
1263:
1261:
1259:
1258:
1254:
1253:
1250:
1247:
1245:
1242:
1240:
1237:
1235:
1232:
1230:
1227:
1225:
1222:
1220:
1217:
1215:
1213:
1212:
1208:
1207:
1205:
1203:
1199:
1196:
1194:
1190:
1186:
1178:
1173:
1171:
1166:
1164:
1159:
1158:
1155:
1144:
1140:
1135:
1130:
1126:
1122:
1117:
1112:
1108:
1104:
1100:
1093:
1090:
1085:
1081:
1076:
1071:
1067:
1063:
1059:
1052:
1049:
1044:
1040:
1035:
1030:
1026:
1022:
1017:
1012:
1008:
1004:
1000:
993:
991:
989:
985:
980:
976:
971:
966:
961:
956:
952:
948:
944:
937:
934:
929:
925:
920:
915:
910:
905:
901:
897:
893:
885:
882:
877:
873:
868:
863:
859:
855:
851:
847:
843:
836:
833:
828:
824:
819:
814:
810:
806:
801:
796:
792:
788:
784:
777:
774:
769:
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1453:Thoracoscopy
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1356:Bronchoscopy
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1286:Laryngectomy
1281:Laryngoscopy
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94:Medical uses
81:
65:lung washing
64:
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27:Lung washing
1591:Capnography
1471:mediastinum
1458:Thoracotomy
1448:Pleurodesis
1416:mediastinum
1340:Tracheotomy
1291:Laryngotomy
1229:Somnoplasty
1224:Septoplasty
1219:Rhinoplasty
396:Lung cancer
221:atelectasis
24:Other names
1778:Categories
1674:Intubation
1581:Spirometry
1463:Chest tube
1407:Chest wall
1265:Sinusotomy
1239:Rhinectomy
1234:Alarplasty
953:(1): 152.
509:StatPearls
417:References
371:Asbestosis
332:surfactant
320:surfactant
308:surfactant
293:surfactant
228:surfactant
205:surfactant
197:osmolarity
104:micrograph
1739:Nebulizer
1530:Spiral CT
1422:diaphragm
1377:Lobectomy
1296:Thyrotomy
1125:1752-1947
1109:(1): 62.
1084:2090-925X
1068:(1): 15.
1025:2077-6624
902:(1): 60.
809:1471-2466
793:(1): 10.
750:2072-1439
702:249956633
411:Silicosis
272:Hypoxemia
225:Exogenous
179:Solutions
84:silicosis
1611:Cytology
1348:bronchus
1313:Lower RT
1202:Upper RT
1143:28270188
1043:28740686
979:35459122
928:35300687
876:36118542
827:18625067
768:28740686
694:35732044
659:37814649
650:10560373
561:72695608
517:28613513
488:25 March
452:19995769
386:COVID-19
365:See also
296:proteins
291:In PAP,
33:ICD-9-CM
1558:CURB-65
1322:trachea
1193:Surgery
1134:5341169
1034:5506114
970:9034602
919:8932062
867:9437756
818:2483254
759:5506114
610:6265382
602:1486961
355:heparin
348:History
276:dypsnea
234:Devices
114:hyaline
1734:Heliox
1431:pleura
1411:pleura
1273:larynx
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515:
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391:Lavage
376:Asthma
304:saline
300:lipids
217:lavage
213:Saline
201:saline
116:globs.
69:saline
1638:Other
1499:Tests
1257:sinus
698:S2CID
606:S2CID
557:S2CID
432:Chest
45:[
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1420:and
1364:lung
1211:nose
1139:PMID
1121:ISSN
1080:ISSN
1039:PMID
1021:ISSN
975:PMID
924:PMID
872:PMID
823:PMID
805:ISSN
764:PMID
746:ISSN
690:PMID
655:PMID
598:PMID
513:PMID
490:2020
448:PMID
298:and
274:and
207:and
158:ARDS
150:ARDS
146:ARDS
142:ARDS
138:ARDS
134:ARDS
126:PAP)
1719:CPR
1129:PMC
1111:doi
1070:doi
1029:PMC
1011:doi
965:PMC
955:doi
914:PMC
904:doi
862:PMC
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736:doi
682:doi
645:PMC
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