Doctors In AIIMS Bhubaneswar ‘Dish-wash’ Woman’s Lungs To Cu
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Doctors in AIIMS Bhubaneswar washed the lungs of a 25-year-old housewife with warm saline water to cure a rare disorder that leaves the organs flooded with protein, causing breathlessness. The patient suffered from Primary Pulmonary Alveolar Proteinosis (PAP) for the past three years.

“In PAP, the accumulated proteins need to be removed. While putting the woman on a ventilator, the right lung was allowed to breathe and the left lung was washed by passing saline water through a nasal tube on January 21. On February 23, the right lung was cleaned while the left one worked. Each lung cleaning took four to six hours in a process called Whole Lung Lavage (WLL).

Around 15 liters of saline was used for each lung,” said Shakti Kumar Bal, assistant professor of pulmonary medicine, who led the team doing the procedure. PAP is a rare disorder and the WLL process is tricky, he said. “Cleaning the first lung was more difficult since the second also did not function fully due to unwanted protein latching on to it as leftover food particles do to dishes. Cleaning the second one was easier as the first one was clean and functioning better,” Bal said.

The woman who earlier needed constant oxygen support was able to walk and breathe freely by February 26, just three days after the cleaning was done PAP is two types. One type is caused by silica dust exposure or certain immune deficiency and the other by unidentified reasons.

Doctors treating the woman said special proteins called surfactant proteins are secreted and removed continuously in the lungs. These proteins are essential for easy expansion and oxygen exchange in the lungs. However, in PAP, these surfactant proteins fail to get removed from the lungs. Eventually, large amounts of such proteins accumulate in the lungs, impair oxygen transfer and cause progressive difficulties in breathing.

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