Randomised comparison of partial liquid ventilation, nebulised perfluorocarbon, porcine surfactant, artificial surfactant, and combined treatments on oxygenation, lung mechanics, and survival in rabbits after saline lung lavage.

OBJECTIVE: To compare gas exchange, lung mechanics, and survival to 12 h in surfactant-depleted lung-injured rabbits, treated with partial liquid ventilation (PLV) with perfluorocarbon, nebulised perfluorocarbon, and porcine or artificial surfactant.
DESIGN: Prospective randomised controlled study.
SETTING: Animal laboratory, University of Edinburgh, UK.
SUBJECTS: Eighty-two adult female New Zealand white rabbits with surfactant deficiency and acute lung injury induced by repeated saline lavage.
INTERVENTIONS: Animals were randomised to one of seven treatments: (a) control (n = 20); (b) PLV with perfluorocarbon PF 5080 (n = 12); (c) nebulised PF 5080 (n = 10); (d) artificial surfactant (n = 10); (e) porcine surfactant (n = 10); (f) artificial surfactant+PLV (n = 10); (g) porcine surfactant+PLV (n = 10).
MEASUREMENTS AND MAIN RESULTS: Arterial blood gases and dynamic compliance (Cdyn) were measured hourly until 12 h. Oxygenation was improved by PLV, porcine surfactant, porcine surfactant+PLV and artificial surfactant+PLV. Cdyn improved after treatment with PLV, porcine surfactant and PLV+porcine surfactant. Survival was greater with PLV and artificial surfactant+PLV. Neither nebulised PF 5080 nor artificial surfactant had a detectable effect.
CONCLUSIONS: PLV, porcine surfactant and combinations of surfactant with PLV improved oxygenation, Cdyn and survival, but none was clearly superior to the others.