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

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.

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.

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.

Partial liquid ventilation and nitric oxide in experimental acute lung injury

2002 ◽  
Vol 38 (5) ◽  
pp. 492-496 ◽  
Author(s):  
MW Davies ◽  
MJ Stewart ◽  
R Chavasse ◽  
G Bayley ◽  
W Butt
Keyword(s):  
Nitric Oxide ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Partial Liquid Ventilation ◽  
Liquid Ventilation
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