Fiberoptic bronchopulmonary lavage for alveolar proteinosis in a patient with only one lung

Bronchopulmonary lavage with a fiberoptic bronchoscope was performed on a patient with alveolar proteinosis and only one lung. Lavage was performed under general anesthesia with continuous monitoring of oxygen saturation. Sequential washing of subsegments of his right upper and middle lobes did not compromise gas exchange to the remaining lower lobe. The patient tolerated the procedure without difficulty and had rapid improvement in pulmonary function and exercise capability, persisting during two months of follow-up. The necessity for cardiopulmonary bypass to provide oxygenation was anticipated and new equipment was designed should it have been required.