Lung management with perfluorocarbon liquid ventilation improves pulmonary function and gas exchange during extracorporeal membrane oxygenation (ECMO).
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| Abstract |
We investigated whether pulmonary function and gas exchange would improve with liquid perfluorocarbon ventilation (LV) during ECMO for severe respiratory failure. Lung injury was induced in 11 young sheep 15.1 +/- 3.7 kg in weight utilizing right atrial injection of 0.07 cc/kg oleic acid followed by saline pulmonary lavage. When (A-a)DO2 > or = 600 mmHg and PaO2 < or = 50 mmHg with FiO2 = 1.0, ECMO was instituted. Animals were then ventilated with either standard ECMO "lung rest" gas ventilator settings (ECMO, n = 5) or with "total" liquid ventilation at standard ventilator device settings (LIQ-ECMO, n = 6) utilizing perflubron (perfluooctyl bromide, Liquivent; Alliance Pharmaceutical Corp.). After 3 hours on ECMO, pulmonary physiologic shunt decreased (ECMO = 88 +/- 11% vs LIQ-ECMO = 31 +/- 1%; p < .001) and pulmonary compliance increased (ECMO = 0.50 +/- 0.06 cc/cmH2O/kg vs. LIQ-ECMO = 1.04 +/- 0.19 cc/cmH2O/kg; p < .001). The ECMO flow rate required to maintain the PaO2 in the 50-80 mmHg range was decreased significantly (ECMO = 116 +/- 14 ml/kg/min vs. LIQ-ECMO = 14 +/- 5 ml/kg/min; p < .001). In this model requiring extracorporeal support for severe respiratory failure, lung management with liquid ventilation improves pulmonary function and gas exchange.
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| Authors | R B Hirschl, A Parent, R Tooley, T Shaffer, M Wolfson, R H Bartlett |
| Journal | Artificial cells, blood substitutes, and immobilization biotechnology (Artif Cells Blood Substit Immobil Biotechnol) Vol. 22 Issue 4 Pg. 1389-96 ( 1994) ISSN: 1073-1199 [Print] England |
| PMID | 7849949 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't) |
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