Benefits and Risks of Bronchopulmonary Lavage: A Review

Studies were conducted in beagle dogs and baboons over a period of 20 years to determine the efficiency of treatment by lung lavage after inhalation of insoluble radioactive particles. The radionuclides tested were 144Ce in fused clay, 238Pu, 239Pu, 241Am, Pu-TBP, PuO2, UO2, and (Pu,U)O2. After inhalation of any of these radionuclides, a single lavage of the two lungs removed almost a quarter of the initial lung burden (ILB) in the two species. When lavage was repeated five times, it removed up to half of the ILB. However, the individual variation was large. For the same radionuclide, lavage efficiency was independent of the ILB. Particle removal was better and continued longer for particles with a long retention half-time. The use of lavage can be combined with that of chelating agents like DTPA. The removal of radioactive particles lengthened survival time and reduced the severity of pathology. The lavage in itself is safe, and does not induce permanent or progressive pathology. The biomedical risk of the lavage mainly depends on the risks inherent in anaesthesia and the health status of the patient.