In a rare, reported case, doctors at Fortis Hospital, Shalimar Bagh have treated a 57-year-old woman suffering from Pulmonary Alveolar Proteinosis (PAP), an extremely rare and potentially life-threatening lung ailment in which abnormal accumulation of protein and fat-like substances in the air sacs of the lungs severely impairs breathing.
The team of doctors led by Dr. Vikas Maurya, senior director & HOD, respiratory medicine & respiratory critical care, Fortis Hospital Shalimar Bagh successfully performed a complex whole lung lavage procedure, using over 30 liters of saline to wash both lungs and remove the accumulated material. The patient made a remarkable recovery and was discharged in a stable condition two days after the whole procedure in both lungs.
The patient had a history of diabetes and hypertension and was presented in the hospital with severe respiratory distress, including persistent cough, fever, and oxygen saturation levels as low as 83% on room air. She was dependent on 5-6 liters of oxygen per minute and had been bedridden for over a month, despite undergoing treatment in her hometown Bihar and later in Kanpur.
Upon admission at Fortis Shalimar Bagh, a CT scan revealed the lung tissues were severely damaged by the disorder. Given her critical condition and risk of progressive respiratory failure, the medical team immediately opted for Whole Lung Lavage – considered the gold standard treatment for PAP.
The procedure, often referred as a “power wash” for the lungs, involves sequentially washing each lung with large volumes of sterile fluid under general anesthesia, while the other lung continues to support breathing. The team of doctors performed the procedure in two stages, one week apart. During the first session, over 11 litres of fluid were used to wash the lung, followed by more than 20 liters in the second session, successfully removing large amounts of proteinaceous material.
Post-procedure, the patient demonstrated significant improvement. Following the first lavage, her oxygen requirement reduced significantly, and following the second session, she was completely weaned off oxygen support, maintaining normal oxygen saturation levels on room air.
Giving details of the case, Dr. Vikas Maurya said, “Pulmonary Alveolar Proteinosis is an extremely rare and potentially life-threatening lung disorder that is often difficult to diagnose and manage. The condition leads to progressive breathlessness, persistent cough, chest discomfort, and severe oxygen deficiency, which can eventually result in respiratory failure if left untreated. Whole Lung Lavage remains the gold standard treatment for PAP; however, it is a highly specialized and resource-intensive procedure that is performed only at select tertiary care centers due to the expertise, infrastructure, anaesthesia support, trained physiotherapist and multidisciplinary coordination required.
“Each lung lavage can take over 5-6 hours and carries significant risks, particularly in patients who are already dependent on oxygen support. Through meticulous planning, close collaboration between our respiratory, anaesthesia, physiotherapy and critical care teams, and strict adherence to clinical protocols, we were able to successfully perform the procedure and achieve an excellent clinical outcome for the patient.”
Naveen Sharma, facility director, Fortis Hospital Shalimar Bagh, said, “This successful outcome reflects the advanced respiratory care capabilities and multidisciplinary expertise available at Fortis Hospital Shalimar Bagh. Managing rare and complex conditions such as Pulmonary Alveolar Proteinosis requires specialized infrastructure, clinical excellence, and coordinated care. Cases like these reinforce the importance of early diagnosis and timely access to advanced treatment, which can significantly improve patient outcomes and quality of life.”
