Delhi doctors perform rare whole lung lavage to treat uncommon lung condition 

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A 57-year-old woman suffering from Pulmonary Alveolar Proteinosis (PAP), a rare and potentially life-threatening lung disorder, has been successfully treated at a Delhi hospital through a complex Whole Lung Lavage procedure, doctors said on Wednesday.

The woman was treated at Fortis Hospital, Shalimar Bagh, where doctors washed both lungs using more than 30 litres of saline in a two-stage procedure to remove the abnormal accumulation of proteinaceous material from the air sacs. She recovered well and was discharged in a stable condition two days after the completion of the procedure.

According to the hospital, PAP is an extremely rare lung disease, with fewer than 100 reported cases in India. The condition leads to the build-up of protein and fat-like substances in the lungs, severely affecting breathing and, if left untreated, can result in respiratory failure.

The patient, who had a history of diabetes and hypertension, was admitted with severe respiratory distress, persistent cough and fever. Her oxygen saturation had dropped to 83 per cent on room air and she required five to six litres of oxygen per minute.

The woman had remained bedridden for more than a month despite receiving treatment in Bihar and later in Kanpur.

A CT scan revealed extensive damage to her lungs, following which doctors decided to perform a Whole Lung Lavage, considered the gold standard treatment for PAP. 

The procedure was carried out one lung at a time under general anaesthesia over two sessions spaced a week apart. More than 11 litres of sterile saline were used during the first session and over 20 litres during the second.

Following the first lavage, the patient’s oxygen requirement reduced significantly. After the second session, she was completely weaned off oxygen support and maintained normal oxygen saturation levels on room air, the hospital said.

Dr Vikas Maurya, Senior Director and Head of Respiratory Medicine and Respiratory Critical Care at the hospital, said Whole Lung Lavage remains the gold standard treatment for PAP but is a highly specialised and resource-intensive procedure performed only at select tertiary care centres.

He said each lung lavage can take over five to six hours and requires close coordination among respiratory medicine, anaesthesia, physiotherapy and critical care teams due to the significant risks involved, particularly in patients dependent on oxygen support.

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