TY - JOUR T1 - Surveillance of whole lung lavage for autoimmune pulmonary alveolar proteinosis in Japan JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P2356 AU - Toshio Ichiwata AU - Shuji Oh-ishi AU - Kenji Uchida AU - Yoshikazu Inoue AU - Toru Arai AU - Haruyuki Ishii AU - Kou Nakata Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P2356.abstract N2 - Aims: Whole lung lavage (WLL) has been widely performed for the treatment of autoimmune pulmonary alveolar proteinosis (aPAP). However its procedures have not been exactly standardized. In order to understand the present status of WLL in Japan, we conducted the national surveillance.Method: Questionnaires were sent to 211 institutions in Japan which had been registered as the database of our Japanese large cohort study of aPAP.Result; 88 institutions answered the questionnaires, where 310 patients with aPAP have been treated. WLL was performed 220 times for 81 patients with 31 institutions. WLL was performed in less than 2 patients with 24/32 institutions and seven or more patients were only 3 institutions. PaO2 (RA) before the initial WLL was 61.7±12.5 Torr. Double lumen tubes for the left side was used in 18/30 institutions. The patients were placed in a lateral position, in which the washed lung was present on the inferior side with 28/30 institutions and in a dorsal position with 33% of institutions. Degassing was performed with 43.3% institutions. Saline at 37 ° was used for lavage in 63.6% institution. Lavage fluid was instilled by volume-controlled lavage method in 62.5%, and by pressure-controlled lavage method in 28.1% of institutions. Extracorporeal membrane oxygenation (ECMO) was used 21 times with 28.1% institutions. WLL was stopped by hypoxemia (n=6) and lavaged fluid leak in a non-washing lung (n=5).Conclusion;The criteria for ECMO application, enforcement of degassing, the posture, the lavaged fluid, the infusion method were various.Funding/Support; This study was supported by grant from Japanese Ministry of Health, Labour, and Welfare (H22-Nanchi-Ippan-146). ER -