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Partial liquid ventilation improves lung function in ventilation-induced lung injury

¹ Dept of Anesthesiology, Erasmus University Rotterdam, Rotterdam, The Netherlands. ² Unidad de Cuidados Intensivos, Hospital de Especialidades "Dr. Bernardo Sepulveda G.", del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, México

CORRESPONDENCE: B. Lachmann, Dept of Anesthesiology (Room Ee 2393), Erasmus University Rotterdam, PO Box 1738, 3000 DR, Rotterdam, The Netherlands. Fax: 31 104089450

Keywords: mechanical ventilation, partial liquid ventilation, ventilation-induced lung injury

Received: March 4, 2000
Accepted January 30, 2001

This work was financially supported by the International Foundation for Clinically Oriented Research (IFCOR), and V. de Anda received a study grant from Consejo Nacional de Ciencia y Tecuología, Mexico. Equipment was made available by Siemens-Elema AB, Solna, Sweden.

Disturbances in lung function and lung mechanics are present after ventilation with high peak inspiratory pressures (PIP) and low levels of positive end-expiratory pressure (PEEP). Therefore, the authors investigated whether partial liquid ventilation can re-establish lung function after ventilation-induced lung injury.

Adult rats were exposed to high PIP without PEEP for 20 min. Thereafter, the animals were randomly divided into five groups. The first group was killed immediately after randomization and used as an untreated control. The second group received only sham treatment and ventilation, and three groups received treatment with perfluorocarbon (10 mL·kg^–1, 20 mL·kg^–1, and 20 ml·kg^–1 plus an additional 5 mL·kg^–1 after 1 h). The four groups were maintained on mechanical ventilation for a further 2-h observation period. Blood gases, lung mechanics, total protein concentration, minimal surface tension, and small/large surfactant aggregates ratio were determined.

The results show that in ventilation-induced lung injury, partial liquid ventilation with different amounts of perflubron improves gas exchange and pulmonary function, when compared to a group of animals treated with standard respiratory care. These effects have been observed despite the presence of a high intra-alveolar protein concentration, especially in those groups treated with 10 and 20 mL of perflubron.

The data suggest that replacement of perfluorocarbon, lost over time, is crucial to maintain the constant effects of partial liquid ventilation.

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