Treatment of accidental inhalation of plutonium oxide by in-vivo pulmonary lavage

The therapeutic role of pulmonary lavage in vivo after plutonium oxide has been inhaled was studied in more than 100 baboons. The technical procedures for pulmonary lavage as a whole, which enable a maximum number of alveolar macrophages to be removed with the rinsing fluid, are described. Study of the physiological and histological consequences does not indicate any long-term pathology, and the lesions observed during the 48 hours following irrigation are rapidly repaired. Efficiency as a function of time since inhalation indicates that one lavage sequence eliminates only 12-25% of the lung burden. Repetition of the treatment by a procedure consisting of 10 such sequences at the rate of one per week enables 60-90% of the retained burden to be eliminated. The mechanism by which the lavage takes effect seems to be a double one - direct elimination in the rinsing fluid and speeded-up lung clearance with a slight ganglionic overburden. The survival rates attained in the animals treated and kept for a long time are compatible with the lung burden remaining after treatment. Detection of an inhibiting effect on pulmonary fibrosis suggests this technique could be used more extensively. (author)