In 8 patients with pulmonary alveolar proteinosis (7 with autoimmune pulmonary alveolar proteinosis and 1 with secondary pulmonary alveolar proteinosis related to Behcet disease), we performed unilateral total pulmonary lavage 41 times (including 2 sessions in which lavage was discontinued) between March 1991 and January 2008. Reasons for discontinuation consisted of severe hypoxemia and leakage of lavage fluid into the non-washed lung. In this study, we describe changes in arterial blood gas and limitations in 41 sessions of unilateral total pulmonary lavage, and report an algorithm for lavage procedures prepared based on our experience and previous studies regarding unilateral total pulmonary lavage.
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