Docs wash woman’s lungs with saline to treat a rare disease

Doctor: Sameer Arbat

A 65-year-old woman from Nagpur was diagnosed with a rare lung disorder, primary alveolar proteinosis (PAP), which affects about 1 person in one lakh people worldwide and is even rarer in India. In PAP, protein gets accumulated inside the lungs leading to a decrease in oxygen exchange.

The protein deposits can be cleared with a complex procedure of whole lung lavage (WLL) in which the lungs are washed. Interventional pulmonologist Dr. Sameer Arbat performed WLL on both lungs of the woman at Wockhardt Hospitals recently.

The targeted lung is connected to a blood water circuit and approximately one liter of saline is filled in the patient’s lung. The other lung is attached to a ventilator. Physiotherapists perform rigorous chest PT to loosen the protein in the lung. The filling and emptying of the lung are performed till the returning fluid becomes clear.

Dr. Arbat said after 10 cycles of saline instillation and drainage, the left lung was washed with 8-liter saline and the right lung with 8.8-liter saline.

“Due to the rarity of the disease and the lack of randomized trials, there are no specific guidelines for the technique of performing WLL. Thanks to our team of experienced doctors, we could perform this procedure to clean the lungs and clear most of the protein deposits. Over the course of eight procedures, we have refined and modified the technique for better outcomes,” Dr. Arbat said.

PAP is a lung condition that is caused by a build-up of proteins, fats, and other substances (collectively called surfactants) in the air sacs of the lungs, called the alveoli. The alveoli are part of the lungs that contain air. It is here gassed between the lungs and the blood is exchanged.

The procedure was successful with no adverse events and the patient was discharged with significant improvement in radiological and clinical condition, as per the team of doctors.

Primary Alveolar Proteinosis (PAP)

  • Proteins, fats, and other substances build up in the air sacs of the lungs.
  • Patients experience problems with breathing, chest pain, weight loss, cough, etc.
  • Doctors hear a crackling sound on listening to the lungs of PAP patients.
  • On confirming it, they recommend other diagnostic tests like lung function, etc.
  • Treatment involves washing out the protein substance from the lung (whole-lung lavage).

Dr Sameer Arbat
Consultant Interventional Pulmonologist
Wockhardt Hospitals, Nagpur

To book an appointment call: +918605604444


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