PT  - JOURNAL ARTICLE
AU  - Pierre Gay
AU  - Benoit Wallaert
AU  - Stefan Nowak
AU  - Jonas Yserbit
AU  - S. Anevlavis
AU  - C. Hermant
AU  - Alban Lovis
AU  - Olivier Menard
AU  - Bernard Maitre
AU  - Thomas Vandermoortel
AU  - Herve Dutau
AU  - Amandine Briault
AU  - Arnaud Bourdin
AU  - Marios Froudarakis
AU  - Jean-Michel Vergnon
TI  - Efficacy of total lung lavage in pulmonary alveolar proteinosis: A multicenter international study of GELF
AID  - 10.1183/13993003.congress-2016.OA3020
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - OA3020
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/OA3020.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/OA3020.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - BACKGROUND: Total Lung Lavage (TLL) is considered as standard of care in Pulmonary Alveolar Proteinosis (PAP). Yet, new therapies have emerged in the treatment of PAP and therefore there is a real need to evaluate the efficacy of TTL in this rare disease.OBJECTIVES: The aim of this study was to assess the efficacy of TTL in patients with PAP.METHODS: We have included 33 patients who underwent TTL from 11 centers, members of the French-Speaking Endoscopy Group (GELF) for analysis. Data collection concerned patient's and disease characteristics, pulmonary function tests (PFTs) before and after the procedure, and technical informations on the procedure.RESULTS: Patients with respiratory insufficiancy at presentation were 22 (68.75%). All patients underwent lung lavage by general anesthesia and selective lung ventilation, except one who underwent flexible bronchoscopy. We noted differences in the technique as 12 (36.36%) patients had percussion during the procedure and only 7(21.2%) underwent two-lungs lavage during one anesthesia. A median of 16.8 L were used to performed TLL (1.0L to 40L). Complications occured in 11 (33.3%) patients and 18(56.25%) of them relapsed in a median period of 16.9 months. No significant changes were found in all PFTs parameters studied, in exception to PaO2 which was after the procedure higher of 6.375 mmHg (p=0.0213 ; [95%CI: 1.03-11.7]) in comparison to before.CONCLUSION: Although the technique of TLL has a variability in its application, due probably to patient's condition, it improves significantly patients' short-term respiratory condition, by improving PaO2. However, long-term effect needs to be confirmed, as many of our patients relapsed.