Telemedicine-Based Functional Monitoring in Pulmonary Alveolar Proteinosis: A Pilot Experience of Post-Whole-Lung Lavage Follow-up
| Author | Lida Fadaizadeh | en |
| Author | Tahereh Parsa | en |
| Author | Kobra Rafie Badi | en |
| Author | Moein Daneshmand | en |
| Orcid | Lida Fadaizadeh [0000-0002-0736-2130] | en |
| Orcid | Kobra Rafie Badi [0000-0002-7719-788X] | en |
| Orcid | Moein Daneshmand [0000-0003-3828-9578] | en |
| Issued Date | 2026-10-31 | en |
| Abstract | Background: Pulmonary alveolar proteinosis (PAP) is a rare lung disorder characterized by intra-alveolar accumulation of surfactant material, resulting in impaired gas exchange and functional limitations. Whole-lung lavage (WLL) remains the standard therapy; however, objective assessment of functional status is important during longitudinal follow-up, particularly for patients who require monitoring outside specialized centers. Objectives: This study evaluated the association between home-based six-minute walk test (6MWT) parameters and the need for repeat WLL in patients with PAP. Methods: In this exploratory observational study, 21 patients with PAP who had undergone at least one WLL were followed using a telemedicine-based monitoring approach. Patients completed home-based 6MWT assessments, including walking distance, oxygen saturation, and heart rate response. Dyspnea severity was assessed using the modified Medical Research Council (mMRC) scale; oxygen dependence and symptom-related parameters were also recorded. Exploratory binary logistic regression analysis was performed to evaluate factors associated with repeat WLL. Results: Patients requiring repeat WLL had significantly shorter 6MWT distances (297.6 ± 109.5 m vs. 429.1 ± 97.4 m, P = 0.009) and higher mMRC dyspnea scores (1.91 ± 0.94 vs. 0.72 ± 0.89, P = 0.002) than those not requiring repeat WLL. In an exploratory multivariable logistic regression analysis, a lower 6MWT distance was associated with the requirement for repeat WLL; however, after adjustment, none of the evaluated predictors showed a statistically significant independent association. Other parameters, including oxygen desaturation and demographic characteristics, were not independently associated with repeat WLL. Conclusions: The home-based 6MWT provides clinically relevant information on functional impairment and may serve as an adjunctive marker for longitudinal monitoring of patients with PAP. Telemedicine-based assessment is a feasible approach for remote collection of functional data; however, its effectiveness in improving clinical outcomes or guiding WLL decisions requires confirmation in larger prospective studies using validated assessment protocols. | en |
| DOI | https://doi.org/10.5812/jcma-173477 | en |
| URI | https://brieflands.com/journals/jcma/articles/173477 | en |
| Keyword | Pulmonary Alveolar Proteinosis | en |
| Keyword | Whole Lung Lavage | en |
| Keyword | Six-minute Walk Test | en |
| Keyword | Telemedicine | en |
| Keyword | Functional Capacity | en |
| Publisher | Brieflands | en |
| Title | Telemedicine-Based Functional Monitoring in Pulmonary Alveolar Proteinosis: A Pilot Experience of Post-Whole-Lung Lavage Follow-up | en |
| Type | Research Article | en |
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