Secondary Logo

Journal Logo

Poster Presentations

THE EFFECT OF PARTIAL LIQUID VENTILATION COMPARED TO SURFACTANT THERAPY ON LUNG VOLUME IN INJURED VENTILATED SMALL LUNGS

Proquitté, H; Hartenstein, S; Kölsch, U; Wauer, R R.; Schmalisch, G

Author Information
  • Free

Besides surfactant therapy (S) partial liquid ventilation (PLV) with perfluorocarbons (PFC) is discussed to treat acute lung injury (ALI) in newborns. Frequently observed improved oxygenation may be attributed to increased lung volume, in particular alveolar recruitment. Thus, we aimed to identify whether PLV compared to S increases the end-expiratory volume of the total lung (LV). In 15 ventilated piglets (age <12h, mean weight 678g) surfactant-depletion was performed by saline-lavage. After that, the animals were randomized to S (n=7) receiving 120mg Curosurf® and to PLV (n=8) receiving PFC (30mL/kg initially and continuous substitution of evaporative losses). Arterial blood-gases, hemodynamics and lung mechanics were measured initially (baseline), immediately after ALI and after 240min treatment. After the piglets were killed a continuous positive end-expiratory pressure (PEEP) of 10cmH2O was applied. With this PEEP the lungs were removed in toto and frozen in fluid N2. After freeze-drying the lungs were cut into lung cubes (LC) with an edge length of 0.7cm. All LC were weighed and LV of the dried lungs was calculated. ANOVA was used to compare both groups. Between S and PLV were no statistically significant differences in the body weight (mean±SD) (S: 679±169g; PLV: 676±156g; p=0.974) and the dry weight of the lungs (1.79±0.49g, vs. 1.64±0.29; p=0.47). Oxygenation index (OI) and ventilatory efficacy index (VEI) were not significantly different between S and PLV at any time. In S compared with PLV, both the number of LC (133±38 vs. 166.5±25), and the calculated LV (38.78±11.1mL vs. 48.54±7.38mL) was lower and statistically close to the significance level (p=0.062). However, calculated density of the dried lung tissue was significantly affected by treatment (S: 46.57±3.95mg/mL vs. PLV 33.75±2.76mg/mL; p<0.0001). Four hrs of PLV in injured ventilated small lungs increased LV by 25% and decreased the density of the tissue by 28% compared to S likely indicating increased lung distension. Although lungs were expanded by PLV, no positive effect on OI and VEI was seen.

Copyright © 2006 by the American Society for Artificial Internal Organs