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The cardiovascular effects of partial liquid ventilation in newborn lambs after experimental meconium aspiration

Gastiasoro-Cuesta, Elena MD; Alvarez-Díaz, Francisco J. PhD; Arnaiz-Renedo, Arantzazu PhD; Fernández-Ruanova, Begoña MD; López-de-Heredia-y-Goya, Jon MD; Román-Etxebarria, Lourdes MD; Alfonso-Sánchez, Luisa F. MD; Valls-i-Soler, Adolf MD

Pediatric Critical Care Medicine: October 2001 - Volume 2 - Issue 4 - p 334-339
Laboratory Investigations

Objective To study the effects of partial liquid ventilation with perfluorocarbon on cardiovascular function, pulmonary gas exchange, and lung mechanics in term newborn lambs with pulmonary hypertension induced by tracheal instillation of human meconium.

Design Prospective, randomized study.

Setting Research Unit at a university-affiliated hospital.

Subjects Twelve term newborn lambs (<6 days old).

Interventions Lambs were studied in two groups (n = 6): meconium aspiration (3–5 ml/kg 20% meconium solution) managed on pressure-limited conventional mechanical ventilation with or without partial liquid ventilation with perfluorocarbon.

Measurements and Main Results Heart rate, systemic and pulmonary arterial pressures, arterial pH and blood gases, cardiac output, and pulmonary mechanics were measured. Partial liquid ventilation in term newborn lambs with experimental meconium aspiration did not alter cardiovascular profile: heart rate, systemic arterial pressure, and cardiac output maintained initial values throughout the experiment. There was a significant improvement in gas exchange (oxygenation increased from values of <100 torr to 338 torr, and ventilation reached normal values in 15 mins). Dynamic compliance increased in 30 mins, reaching basal values (1.1 ± 0.3 ml/cm H2O per kg). Despite the good response (blood gases and cardiovascular profile) to partial liquid ventilation in meconium aspiration syndrome, pulmonary hypertension did not decrease.

Conclusions Partial liquid ventilation with perfluorocarbon could be a good noninvasive alternative technique that improves gas exchange and pulmonary mechanics in meconium aspiration syndrome without impairing cardiovascular function.

From the Neonatal Intensive Care Unit (Drs. López-de-Heredia-y-Goya, Valls-i-Soler, Román-Etxebarria), the Research Unit on Experimental Neonatal Respiratory Physiology (Drs. Gastiasoro-Cuesta, Alvarez-Díaz, Arnaiz-Renedo, Fernández-Ruanova), and Paediatric Surgery (Dr. Alfonso-Sánchez), Department of Paediatrics, Hospital of Cruces and University of the Basque Country Medical School, Barakaldo, Bizkaia, Spain.

Address requests for reprints to: Prof. Adolf Valls-i-Soler, Neonatal Intensive Care Unit, Department of Pediatrics, Hospital de Cruces, Plaza de Cruces s/n, Barakaldo E-48903, Bizkaia, Spain. Fax: 34 4 600 60 44. E-mail: enadolf@retemail.es

Supported, in part, by the Foundation for Investigation of the Spanish Ministry of Health (FIS) (Grants 95/1348, 95/1332, and 98/0767) and the Department of Education of the Basque Government (Grant BFI 93.046).

This article’s abstract appears in Japanese translation on page 357 of this issue.

© 2001 Lippincott Williams & Wilkins, Inc.