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.
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.
Authors: Peter M Spieth; Lilla Knels; Michael Kasper; André Domingues Quelhas; Bärbel Wiedemann; Amelie Lupp; Matthias Hübler; Antonio Giannella Neto; Antonio Gianella Neto; Thea Koch; Marcelo Gama de Abreu Journal: Intensive Care Med Date: 2006-11-08 Impact factor: 17.440
Authors: P M Spieth; A Güldner; A R Carvalho; M Kasper; P Pelosi; S Uhlig; T Koch; M Gama de Abreu Journal: Br J Anaesth Date: 2011-06-07 Impact factor: 11.719
Authors: Peter M Spieth; Andreas Güldner; Robert Huhle; Alessandro Beda; Thomas Bluth; Dierk Schreiter; Max Ragaller; Birgit Gottschlich; Thomas Kiss; Samir Jaber; Paolo Pelosi; Thea Koch; Marcelo Gama de Abreu Journal: Crit Care Date: 2013-10-31 Impact factor: 9.097
Authors: Renata Salatti Ferrari; Leonardo Dalla Giacomassa Rocha Thomaz; Lucas Elias Lise Simoneti; Jane Maria Ulbrich; Cristiano Feijó Andrade Journal: J Bras Pneumol Date: 2019-03-28 Impact factor: 2.624
Authors: Alysson Roncally S Carvalho; Frederico C Jandre; Alexandre V Pino; Fernando A Bozza; Jorge Salluh; Rosana Rodrigues; Fabio O Ascoli; Antonio Giannella-Neto Journal: Crit Care Date: 2007 Impact factor: 9.097