TY - JOUR T1 - Whole lung lavage efficacy in pulmonary alveolar proteinosis (PAP) is influenced by the infusion volume? JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2015.PA3816 VL - 46 IS - suppl 59 SP - PA3816 AU - Francesca Mariani AU - Elena Paracchini AU - Ilaria Campo AU - Zamir Kadija AU - Carmine Tinelli AU - Maria Chiara Mennitti AU - Antonio Ciuffreda AU - Giuseppe Rodi AU - Maurizio Luisetti Y1 - 2015/09/01 UR - http://erj.ersjournals.com/content/46/suppl_59/PA3816.abstract N2 - Rationale: Whole lung lavage (WLL) is the current standard of care for PAP; WLL is not a standardized procedure, moreover it is highly invasive and is performed under general anesthesia. During the lavage, chest wall percussion is added when the outflow, initially milky, becomes clear. Lavage and percussion are continued until the outflow fluid became completely clear, which may take 3 hrs and an average of 15L saline for a single lung. The complications are rare, consisting mostly of hypoxemia, hydropneumothorax, ARDS, and post-procedure infections.Aims: Our aim is to demonstrate that the efficacy of WLL remains unaltered by using a reduced volume of saline.Methods: Functional data (FEV1, FVC, TLC, FEV1/VC, DLCO) and PaO2 were collected from 15 PAP patients who underwent WLL, at the baseline and 1,3,6 months after the lavage. The amount of 15L saline for single lung was used in 8 patients. In order to optimize WLL procedure, in 7 patients the infusion was reduced to 8L and chest percussion was started in concomitance with the first aliquot infusion.Results: We compared the parameters at the baseline and 1,3,6 months after the lavage and we did not find any statistically significant difference, although we can identify a positive trend of all the functional parameters considered, in the patients group lavaged with 8L saline.Conclusions: Our preliminary data suggest the possibility to reduce the infusion volume (with an earlier clapping) and consequently the time of the procedure. Considering the complexity of the WLL and the risk of a prolonged anesthesia, it could be an advantage in terms of safety of the procedure. ER -