High-Frequency Oscillatory Ventilation, Partial Liquid Ventilation, or Conventional Mechanical Ventilation in NewbornPiglets with Saline Lavage-Induced Acute Lung Injury

Neonatology ◽  
1998 ◽  
Vol 75 (2) ◽  
pp. 118-129 ◽  
Author(s):  
Pieter L.J. Degraeuwe ◽  
Frederik B.J.M. Thunnissen ◽  
Gijs D. Vos ◽  
Carlos E. Blanco
Keyword(s):  
Mechanical Ventilation ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
High Frequency ◽  
Conventional Mechanical Ventilation ◽  
High Frequency Oscillatory Ventilation ◽  
Partial Liquid Ventilation ◽  
Liquid Ventilation ◽  
High Frequency Oscillatory ◽  
Saline Lavage

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.

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