Hemodynamic effects of partial liquid ventilation with perfluorocarbon in acute lung injury.

ABSTRACT

OBJECTIVE: To assess the effect of partial liquid ventilation with perfluorocarbons on hemodynamics and gas exchange in large pigs with induced acute lung injury (ALI). DESIGN: Randomized, prospective, double-control, experimental study. Experimental intensive care unit of a university. MATERIALS Eighteen large pigs (50 +/- 5 kg body weight) with an average anterior posterior thoracic diameter of 24 cm and induced acute lung injury. INTERVENTIONS: All animals were surfactant depleted by lung lavage to a PaO2 below 100 mmHg and randomized to receive either perflubron (n = 6) or saline (n = 6) in five intratracheal doses of 5 ml/kg at 20-min intervals, or no instillation (n = 6). MEASUREMENTS AND RESULTS: In all animals heart rate, arterial pressures, pulmonary pressures, cardiac output and blood gases were recorded at 20-min intervals. There was no deleterious effect on any hemodynamic parameter in the perflubron group, whereas systolic and mean pulmonary arterial pressure values showed a persistent decrease after the first 5 ml/kg of perflubron, from 48.7 +/- 14.1 to 40.8 +/- 11.7 mmHg and from 39.7 +/- 13.2 to 35.2 +/- 12.0 mmHg, respectively. Perflubron resulted in a significant (ANOVA P < 0.01), dose-dependent increase in PaO2 values from 86.3 +/- 22.4 to a maximum of 342.4 +/- 59.4 mmHg at a dose of 25 ml/kg; the other groups showed no significant increase in PaO2. CONCLUSIONS: Tracheal instillation of perflubron in induced ALI results in a dose-dependent increase in PaO2 and has no deleterious effect on hemodynamic parameters.