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Measurements of Alveolar pO2 Using 19F-MRI in Partial Liquid Ventilation

Heussel, Claus Peter MD, PD Dr med*; Scholz, Alexander MD; Schmittner, Marc MD; Laukemper-Ostendorf, Simone Dr rer nat*; Schreiber, Wolfgang G. PD Dr rer nat*; Ley, Sebastian MD; Quintel, Michael MD, PD Dr med; Weiler, Norbert MD, Prof Dr med†§; Thelen, Manfred MD, Prof Dr med*; Kauczor, Hans-Ulrich MD, PD Dr med

doi: 10.1097/01.rli.0000077056.41954.eb
Original Article

Rationale and Objectives: Partial liquid ventilation using Perfluorcarbon (PFC) is an innovative treatment of acute respiratory distress syndrome. However, the underlying mechanisms are not totally clear. The aim was to investigate the distribution of oxygen partial pressure within the PFC-filled lung (ppO2).

Methods: Nine pigs underwent partial liquid ventilation, receiving 20 mL PFC/kg bodyweight (bw). Measurements were obtained by a chemical shift selective TurboFLASH sequence at different axial lung levels. ppO2 was calculated from 19F-MRI by nonlinear curve T1-fitting technique after noise correction.

Results: Quantification and distribution of ppO2 was performed successfully. A narrow relationship of the inspiratory O2 fraction and ppO2, as well as a significant ventral-to-dorsal gradient of ppO2 (ventral:dependent lung = 1.9:1) were detected in all subjects and slice positions.

Conclusions: In vivo measurement of local ppO2 gains new and clinical important insights into the physiology of PLV. The previously unknown ppO2 gradient within PFC fits to distribution of perfusion. Dependent lung regions appear to have limited access to O2 from central airways.

From the *Department of Radiology, Johannes Gutenberg-University, Mainz, Germany; †Department of Anesthesiology, Johannes Gutenberg-University, Mainz, Germany; ‡Anesthesia and Intensive Care, University Hospital Mannheim, Germany; §Anesthesia and Intensive Care, Christian-Albrecht-University, Kiel, Germany; and ¶German Cancer Research Center, Radiological Diagnostics and Therapy, Heidelberg, Germany.

Received February 25, 2003; and accepted for publication April 18, 2003.

Supported by a grant from the ‘Mainzer Forschungsförderungsprogramm des Fachbereichs Medizin’ (MAIFOR), 1999.

Reprints: PD Dr. Claus Peter Heussel, Department of Radiology, Johannes Gutenberg-University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany. E-mail:

© 2003 Lippincott Williams & Wilkins, Inc.