Alveolar protein deposition was first recognized in 1958, but effective treatment was lacking. It was not until 1964 that Ramirez Rivera, an American physician, introduced whole lung lavage as a clinical treatment for alveolar protein deposition. Currently, whole lung lavage remains the mainstay of treatment for alveolar protein deposition. Indications: Clear diagnosis of alveolar protein deposition, in principle, only for idiopathic alveolar protein deposition; arterial partial pressure of oxygen less than 60 mmHg; alveolar arterial partial pressure of oxygen less than 40 mmHg; intrapulmonary shunt greater than 10%; significant dyspnea at rest or during activity. 2, contraindications: those who cannot tolerate general anesthesia; those who cannot tolerate unilateral lung ventilation; those with severe lung infection. 3.Preparation for whole lung lavage: Perform a thorough physical examination of the patient and perform chest X-ray, electrocardiogram, pulmonary function, blood gas analysis and routine laboratory tests. Prepare physical oscillator, 37°C saline 10L to 20L and Carlens double-lumen endotracheal tube, and ultra-fine bronchoscope if available. Staffing: experienced internists, anesthesiologists and nurses. 4. Patient preparation: No food and water on the day of irrigation. General anesthesia is required and should be performed in the operating room. Pethidine 1mg/kg and atropine 0.5mg should be injected 30min before operation. Anesthesia should be maintained by continuous pumping of isoproterenol 4-8 mg/kg.h and intermittent inotropic agents. Intraoperative monitoring of electrocardiography, oxygen saturation, blood pressure, airway pressure, etc. should be performed. 5.Irrigation procedure: (1) Patient position: Generally, the patient is in the lateral position, with the irrigation side underneath, which can ensure that the irrigation fluid will not enter the opposite side and affect oxygenation. However, some scholars suggest that the irrigated side is on top, which can reduce the blood flow on that side and thus achieve a better ventilation/blood flow ratio; in addition, this position is conducive to percussion on the irrigated side in order to make the irrigation adequate. (2) Safety assessment: unilateral lung function assessment should be performed before lavage: unilateral ventilation with pure oxygen, low positive end-expiratory pressure, and closure of the lavage side for 20 min to see the oxygen and situation. (3) Generally lavage the more severely diseased side of the lung first, and if there is no significant difference, choose the left side. (4) Continuous infusion of 37℃ saline by gravity, the amount of fluid instilled each time is based on the patient’s tidal volume, if a large amount of fluid is injected in a short period of time it can lead to alveolar pneumatic injury. Physical shock or percussion of the lung on the irrigated side can be given during the infusion process to facilitate the shedding of lipoproteins in the alveoli. The fluid can be aspirated at the end of instillation, taking care to remove it as cleanly as possible. The procedure is repeated until the lavage fluid changes from milk-like to clear and transparent. Approximately 10,000 to 20,000 ml of lung is lavaged unilaterally. (5) After lavage, the residual fluid should be aspirated as much as possible, and fibrinoscopy may be applied if necessary. (6) If the patient is well oxygenated, the endotracheal tube can be removed after awakening and the patient can be returned to the ward after 1 hour of observation by nasal cannula with oxygen. (7) Bilateral lung lavage can be performed on the same day, or contralateral lavage can be performed on a later day, depending on the recovery of lung function on the lavage side. In general, one side of the lung can be lavaged 1 hour after the end of lavage. 6.Post-irrigation precautions: (1) A few patients may develop post-irrigation pulmonary edema, pay attention to the patient’s breathing and oxygenation, pulmonary signs, X-ray examination if necessary, and increase the oxygen concentration and appropriate diuresis depending on the specific situation. (2) Since irrigation may have similar effects to hemodialysis, resulting in hydroelectric acid-base imbalance, mainly hypokalemia and metabolic acidosis, pay attention to the postoperative acid-base situation and electrolyte changes, and correct them if necessary. (3) There is a possibility of lavage induced airway spasm, and β2 agonist inhalation can be given after surgery. (4) To prevent opportunistic infection, antibiotics can be given after surgery. (1) The position of tracheal intubation is crucial to the success of the operation. (2) Physical shock is given during lavage to facilitate adequate clearance of lipoproteins from the alveoli. (3) It is important to remove the residual fluid after lavage. Most patients respond well to whole lung lavage, but some patients still require repeated lavage at intervals of 6-12 months. Overall, whole lung lavage is a safe and effective treatment and is currently the first choice for the treatment of alveolar protein deposition, resulting in improvements in symptoms, physiological indicators and imaging indices.