A Case of Alveolar Proteinosis Treated by Early Whole Lung Lavage in a Patient Unsuitable for Extracorporeal Membrane Oxygenation

A 47-year-old man had undergone unilateral whole-lung lavage and bilateral whole-lung lavage 9 and 2 times, respectively, during the previous 4 years. Seven out of the 11 treatments were performed with extracorporeal membrane oxygenation（ECMO）support. However, obtaining bilateral femoral venous access gradually became difficult due to a marked increase in proliferation of connective tissue around the blood vessel.When his medical condition worsened again, we decided to perform unilateral whole lung lavage before hypoxemia became serious, in order to avoid the use of ECMO. As a result, the operation could be completed without ECMO support.Early whole-lung lavage may eliminate the need for ECMO support in patients with pulmonary alveolar proteinosis in whom it is difficult to secure vascular access.