Is or could lung lavage be used to treat or at least reduce the time required on a respirator for COVID19 patients?
Could bronchial washing (as used in pulmonary alveolar proteinosis and some forms of pneumonia) be used to treat or at least reduce the length of time a patient suffering from COVID-19 required mechanical respiration?
In addition to alleviating the pneumonia symptoms perhaps the saline flushing solution could be formulated with some type of soaping agent that was still compatible with the respiratory tract since the virus has been shown to be susceptible.
Assuming the procedure could be run continuous on each bronchus for the duration of the virus life cycle (how long is this?) then you could destroy all traces of the virus (unless it remained dormant within a host cell).
Youtube video showing procedure
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The current guidelines for treatment of Adult Respiratory Distress Syndrome do not recommend such treatment.
In SARDS associated with covid-19 disease there is alveolar collapse due to infection and death of the surfactant making pneumocytes lining the alveoli. the recommendation is to generally run these patients on the dry side while being ventilated as there is a tendency to fluid overload the lungs. Adding fluid with pulmonary irrigation sounds counterproductive and is not going to correct the underlying issue of a lack of surfactant.
bmjopenrespres.bmj.com/content/6/1/e000420.full Guidelines on the management of acute respiratory distress syndrome
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