[A retrospective study of the perioperative complications following whole lung lavage in the treatment of pulmonary alveolar proteinosis].

Objective: To evaluate the safety of the procedures of whole lung lavage(WLL) for pulmonary alveolar proteinosis(PAP) in perioperative period. Methods: In this retrospective study, we collected clinical data from 78 WLL procedures of PAP patients from January 2006 to June 2016 in Guangzhou Institute of Respiratory Disease. The causes of perioperative complications were analyzed. Results: Eighteen (23.07%) of the 78 procedures developed complications, including pleural effusion( n =4), pneumonia( n =4), cardiac failure( n =2), cardiac arrhythmia ( n =2), pneumothorax( n =2), atelectasis( n =1), lung edema( n =1), laryngeal edema( n =1), pleural effusion and pneumonia( n =1). All complications were mild and easy to treat. Seventy-four procedures had successful extubation, but 4 procedures developed a prolonged time of extubation. Age, DSS, PaCO(2,)FEV(1,)lavage volume, lavage times and underlying diseases were not predictors for any complications(each P >0.05). High fluid recovering rate had a protective effect against the occurring of complications ( Wald =7.672, OR <0.01, P <0.05). Conclusions: Whole lung lavage was a safe procedure in the treatment of PAP. Complications could recovery after proper therapy. The perioperative complications showed a correlation with low fluid recover rate. Operation under guideline was the key to avoid complications.