Annals of Cardiac Anaesthesia · Published 2026-04-01 · DOI 10.4103/aca.aca_262_25
Whole lung lavage (WLL) for pulmonary alveolar proteinosis, performed under one-lung ventilation (OLV), illustrates the dynamic interplay between alveolar expansion and pulmonary vascular responses. Instillation of warm saline into the nonventilated lung compresses pulmonary vessels, mimicking hypoxic pulmonary vasoconstriction and enhancing oxygenation. Conversely, drainage of the saline relieves vascular compression, worsens ventilation–perfusion (V/Q) mismatch, and leads to a decline in oxygenation. This cyclical pattern underscores the physiological shifts that influence oxygenation during WLL.
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