Continuous tracheal gas insufflation during partial liquid ventilation in juvenile rabbits with acute lung injury

2004 ◽  
Vol 96 (4) ◽  
pp. 1415-1424 ◽  
Author(s):  
Guangfa Zhu ◽  
Thomas H. Shaffer ◽  
Marla R. Wolfson
Keyword(s):  
Acute Lung Injury ◽  
Gas Exchange ◽  
Lung Injury ◽  
Combined Treatment ◽  
Peak Inspiratory Pressure ◽  
Oxygenation Index ◽  
Lung Mechanics ◽  
Partial Liquid Ventilation ◽  
Liquid Ventilation ◽  
Tracheal Gas Insufflation

To examine the hypothesis that combined treatment with tracheal gas insufflation (TGI) and partial liquid ventilation (PLV) may improve pulmonary outcome relative to either treatment alone in acute lung injury (ALI), saline lavage lung injury was induced in 24 anesthetized, ventilated juvenile rabbits that were then randomly assigned to receive ( n = 6/group) 1) conventional mechanical ventilation (CMV) alone, 2) continuous TGI at 0.5 l/min, 3) PLV with perfluorochemical liquid, and 4) combined TGI and PLV (TGI + PLV), and subsequently ventilated with minimized pressures and tidal volume (Vt) to keep arterial Po2 (PaO2) >100 Torr and arterial Pco2 (PaCO2) at 45-60 Torr for 4 h. Gas exchange, lung mechanics, myeloperoxidase, IL-8, and histomorphometry [including expansion index (EI)] were assessed. The CMV group showed no improvement in lung mechanics and gas exchange; all treated groups had significant increases in compliance, PaO2, ventilation efficacy index (VEI), and EI, and decreases in PaCO2, oxygenation index, physiological dead space-to-Vt ratio (Vd/Vt), myeloperoxidase, and IL-8, relative to the CMV group. TGI resulted in lower peak inspiratory pressure, Vt, Vd/Vt, and greater VEI vs. PLV group; PLV resulted in greater compliance, PaO2, and EI vs. TGI. TGI + PLV resulted in decreased peak inspiratory pressure, Vt, Vd/Vt, and increased VEI compared with TGI, improved compliance and EI compared with PLV, and a further increase in PaO2 and oxygenation index and a decrease in PaCO2 vs. either treatment alone. These results indicate that combined treatment of TGI and PLV results in improved pulmonary outcome than either treatment alone in this animal model of ALI.

Combining partial liquid ventilation with nitric oxide to improve gas exchange in acute lung injury

1997 ◽  
Vol 23 (2) ◽  
pp. 163-169 ◽  
Author(s):  
R.-J. M. Houmes ◽  
A. Hartog ◽  
S. J. C. Verbrugge ◽  
S. Böhm ◽  
B. Lachmann
Keyword(s):  
Nitric Oxide ◽  
Acute Lung Injury ◽  
Gas Exchange ◽  
Lung Injury ◽  
Partial Liquid Ventilation ◽  
Liquid Ventilation

Partial liquid ventilation improves gas exchange and increases EELV in acute lung injury

1998 ◽  
Vol 84 (5) ◽  
pp. 1566-1572 ◽  
Author(s):  
Paul G. Gauger ◽  
Michael C. Overbeck ◽  
Sean D. Chambers ◽  
Christine I. Cailipan ◽  
Ronald B. Hirschl
Keyword(s):  
Acute Lung Injury ◽  
Oleic Acid ◽  
Gas Exchange ◽  
Lung Injury ◽  
Null Point ◽  
Partial Liquid Ventilation ◽  
Body Plethysmography ◽  
Liquid Ventilation ◽  
Before And After ◽  
Point Body

Gas exchange is improved during partial liquid ventilation with perfluorocarbon in animal models of acute lung injury. The specific mechanisms are unproved. We measured end-expiratory lung volume (EELV) by null-point body plethysmography in anesthetized sheep. Measurements of gas exchange and EELV were made before and after acute lung injury was induced with intravenous oleic acid to decrease EELV and worsen gas exchange. Measurements of gas exchange and EELV were again performed after partial liquid ventilation with 30 ml/kg of perfluorocarbon and compared with gas-ventilated controls. Oxygenation was significantly improved during partial liquid ventilation, and EELV (composite of gas and liquid) was significantly increased, compared with preliquid ventilation values and gas-ventilated controls. We conclude that partial liquid ventilation may directly recruit consolidated alveoli in the lung-injured sheep and that this may be one mechanism whereby gas exchange is improved.

Comparative Effects of Vaporized Perfluorohexane and Partial Liquid Ventilation in Oleic Acid– induced Lung Injury

2006 ◽  
Vol 104 (2) ◽  
pp. 278-289 ◽  
Author(s):  
Marcelo Gama de Abreu ◽  
André Domingues Quelhas ◽  
Peter Spieth ◽  
Götz Bräuer ◽  
Lilla Knels ◽  
...  
Keyword(s):  
Oleic Acid ◽  
Gas Exchange ◽  
Lung Injury ◽  
Diffuse Alveolar Damage ◽  
Lung Mechanics ◽  
Partial Liquid Ventilation ◽  
Positive End Expiratory Pressure ◽  
Liquid Ventilation ◽  
Mechanically Ventilated ◽  
Residual Capacity

Background It is currently not known whether vaporized perfluorohexane is superior to partial liquid ventilation (PLV) for therapy of acute lung injury. In this study, the authors compared the effects of both therapies in oleic acid-induced lung injury. Methods Lung injury was induced in 30 anesthetized and mechanically ventilated pigs by means of central venous infusion of oleic acid. Animals were assigned to one of the following groups: (1) control or gas ventilation (GV), (2) 2.5% perfluorohexane vapor, (3) 5% perfluorohexane vapor, (4) 10% perfluorohexane vapor, or (5) PLV with perfluorooctane (30 ml/kg). Two hours after randomization, lungs were recruited and positive end-expiratory pressure was adjusted to obtain minimal elastance. Ventilation was continued during 4 additional hours, when animals were killed for lung histologic examination. Results Gas exchange and elastance were comparable among vaporized perfluorohexane, PLV, and GV before the open lung approach was used and improved in a similar fashion in all groups after positive end-expiratory pressure was adjusted to optimal elastance (P < 0.05). A similar behavior was observed in functional residual capacity (FRC) in animals treated with vaporized perfluorohexane and GV. Lung resistance improved after recruitment (P < 0.05), but values were higher in the 10% perfluorohexane and PLV groups as compared with GV (P < 0.05). Interestingly, positive end-expiratory pressure values required to obtain minimal elastance were lower with 5% perfluorohexane than with PLV and GV (P < 0.05). In addition, diffuse alveolar damage was significantly lower in the 5% and 10% perfluorohexane vapor groups as compared with PLV and GV (P < 0.05). Conclusions Although the use of 5% vaporized perfluorohexane permitted the authors to reduce pressures needed to stabilize the lungs and was associated with better histologic findings than were PLV and GV, none of these perfluorocarbon therapies improved gas exchange or lung mechanics as compared with GV.

Extended high-frequency partial liquid ventilation in lung injury: gas exchange, injury quantification, and vapor loss

2003 ◽  
Vol 95 (3) ◽  
pp. 1248-1258 ◽  
Author(s):  
Allan Doctor ◽  
Eman Al-Khadra ◽  
Puay Tan ◽  
Kenneth F. Watson ◽  
Diana L. Diesen ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Lung Injury ◽  
High Frequency ◽  
Oxygenation Index ◽  
High Frequency Oscillatory Ventilation ◽  
Partial Liquid Ventilation ◽  
Dependent Lung ◽  
Liquid Ventilation ◽  
Evaporative Loss ◽  
High Frequency Oscillatory

High-frequency oscillatory ventilation with perflubron (PFB) reportedly improves pulmonary mechanics and gas exchange and attenuates lung injury. We explored PFB evaporative loss kinetics, intrapulmonary PFB distribution, and dosing strategies during 15 h of high-frequency oscillation (HFO)-partial liquid ventilation (PLV). After saline lavage lung injury, 15 swine were rescued with high-frequency oscillatory ventilation ( n = 5), or in addition received 10 ml/kg PFB delivered to dependent lung [ n = 5, PLV-compartmented (PLV(C))] or 10 ml/kg distributed uniformly within the lung [ n = 5, PLV(U)]. In the PLV(C) group, PFB vapor loss was replaced. ANOVA revealed an unsustained improvement in oxygenation index in the PLV(U) group ( P = 0.04); the reduction in oxygenation index correlated with PFB losses. Although tissue myeloperoxidase activity was reduced globally by HFO-PLV ( P < 0.01) and regional lung injury scores (lung injury scores) in dependent lung were improved ( P = 0.05), global lung injury scores were improved by HFO-PLV ( P < 0.05) only in atelectasis, edema, and alveolar distension but not in cumulative score. In our model, markers of inflammation and lung injury were attenuated by HFO-PLV, and it appears that uniform intrapulmonary PFB distribution optimized gas exchange during HFO-PLV; additionally, monitoring PFB evaporative loss appears necessary to stabilize intrapulmonary PFB volume.

Combining Partial Liquid Ventilation and Prone Position in Experimental Acute Lung Injury 

1999 ◽  
Vol 91 (3) ◽  
pp. 796-796 ◽  
Author(s):  
Martin Max ◽  
Ralf Kuhlen ◽  
Frank López ◽  
Stefan Matthias Reyle-Hahn ◽  
Jan Hinrich Baumert ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Gas Exchange ◽  
Lung Injury ◽  
Prone Position ◽  
Supine Position ◽  
Lung Lavage ◽  
Partial Liquid Ventilation ◽  
Additive Effects ◽  
Hemodynamic Parameters ◽  
Liquid Ventilation

Background Partial liquid ventilation (PLV) and prone position can improve arterial oxygen tension (PaO2) in acute lung injury (ALI). The authors evaluated additive effects of these techniques in a saline lung lavage model of ALI. Methods ALI was induced in 20 medium-sized pigs (29.2+/-2.5 kg body weight). Gas exchange and hemodynamic parameters were determined in both supine and prone position in all animals. Thereafter, one group was assigned to PLV with two sequential doses of 15 ml/kg of perfluorocarbon (n = 10); the second group was assigned to gaseous ventilation (n = 10). Gas-exchange and hemodynamic parameters were determined at corresponding time points in both groups in prone and supine position. Results In the PLV group, positioning the animals prone resulted in an increase of PaO2 prior to PLV and during PLV with both doses of perfluorocarbon when compared to ALI. PLV in supine position was only effective if 30 ml/kg of perfluorocarbon was applied. In the gaseous ventilation group, PaO2 increased reproducibly compared with ALI when the animals were turned prone. A significant additive improvement of arterial oxygenation was observed during combined therapy with 30 ml/kg of perfluorocarbon and prone position in the PLV group compared with either therapy alone. Conclusions The authors conclude that combining PLV with prone position exerts additive effects on pulmonary gas exchange in a saline lung lavage model of ALI in medium-sized pigs.

Sign in / Sign up

Export Citation Format

Share Document