32997 Total lung lavage (unilateral)

Name of the Procedure:

Total Lung Lavage (Unilateral)

• Common Names: Lung irrigation, Lung washing
• Technical Term: Unilateral Whole Lung Lavage

Summary

Total Lung Lavage (Unilateral) is a medical procedure where one lung is flushed with a sterile solution to remove excess mucus, fluids, or other substances. This helps improve lung function and is typically performed on one lung at a time.

Purpose

• Medical Condition: Primarily used to treat conditions like pulmonary alveolar proteinosis (PAP), where protein-like substances accumulate in the lung's air sacs.
• Goals: To clear the lung of these substances, thereby improving breathing, oxygen absorption, and overall lung function.

Indications

• Symptoms: Chronic cough, shortness of breath, fatigue, and frequent lung infections.
• Patient Criteria: Patients diagnosed with pulmonary alveolar proteinosis (PAP) or other conditions resulting in the accumulation of materials within the lungs.

Preparation

• Instructions: Patients are typically required to fast for a specific period before the procedure. Medication adjustments may also be necessary.
• Assessments: Chest X-rays, CT scans, and pulmonary function tests to assess lung condition and suitability for the procedure.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Intubation: A breathing tube is inserted into the patient's windpipe.
3. Isolation: One lung is isolated using a special tube.
4. Lavage: The isolated lung is filled with a saline solution and gently agitated to loosen mucus and proteins.
5. Drainage: The solution, along with the loosened material, is then drained out.
6. Repeat: The process may be repeated multiple times to ensure thorough cleaning.
   • Tools: Bronchoscope, specialized lavage catheter, saline solution, suction apparatus.

Duration

The procedure typically takes 2-4 hours, depending on the amount of material to be removed and the patient's response.

Setting

Performed in a hospital, usually in an operating room equipped for thoracic procedures.

Personnel

• Thoracic surgeon or pulmonologist
• Anesthesiologist
• Surgical nurses
• Respiratory therapists

Risks and Complications

• Common Risks: Sore throat from intubation, minor bleeding, temporary fever.
• Rare Risks: Infection, lung injury, fluid imbalance, anesthesia-related complications.
• Management: Close monitoring, antibiotics if infection occurs, supportive care for other complications.

Benefits

• Expected Benefits: Improved lung function, better breathing, fewer infections.
• Realization Time: Benefits may be noticed shortly after recovery, with continued improvement over weeks.

Recovery

• Post-Procedure Care: Close monitoring in a recovery room or ICU for a day or two.
• Instructions: Avoid strenuous activities for a few weeks, follow-up pulmonary function tests, and possible repeat procedures for the other lung if needed.
• Recovery Time: Typically, a few weeks to resume normal activities; varies by individual.

Alternatives

• Options: Inhaled medications, oxygen therapy, other supportive treatments.
• Pros and Cons: Alternatives may be less invasive but might not be as effective for severe conditions like PAP.

Patient Experience

• During: Under general anesthesia, the patient remains unconscious with no sensation or awareness of the procedure.
• After: Some throat discomfort, mild chest soreness, and tiredness are common. Pain management includes medications and supportive care measures.