Effects of Vaporized Perfluorocarbon on Pulmonary Blood Flow and Ventilation/Perfusion Distribution in a Model of Acute Respiratory Distress Syndrome

Background Perfluorocarbon (PFC) liquids are known to improve gas exchange and pulmonary function in various models of acute respiratory failure . Vaporization has been recently reported as a new method of delivering PFC to the lung. Our aim was to study the effect of PFC vapor on the ventilation/perfusion (&OV0312;A/&OV0422;) matching and relative pulmonary blood flow (&OV0422;rel) distribution. Methods In nine sheep, lung injury was induced using oleic acid. Four sheep were treated with vaporized perfluorohexane (PFX) for 30 min, whereas the remaining sheep served as control animals. Vaporization was achieved using a modified isoflurane vaporizer. The animals were studied for 90 min after vaporization. &OV0312;A/&OV0422; distributions were estimated using the multiple inert gas elimination technique. Change in &OV0422;rel distribution was assessed using fluorescent-labeled microspheres. Results Treatment with PFX vapor improved oxygenation significantly and led to significantly lower shunt values (P < 0.05, repeated-measures analysis of covariance). Analysis of the multiple inert gas elimination technique data showed that animals treated with PFX vapor demonstrated a higher &OV0312;A/&OV0422; he-terogeneity than the control animals (P < 0.05, repeated-measures analysis of covariance). Microsphere data showed a redistribution of &OV0422;rel attributable to oleic acid injury. &OV0422;rel shifted from areas that were initially high-flow to areas that were initially low-flow, with no difference in redistribution between the groups. After established injury, &OV0422;rel was redistributed to the nondependent lung areas in control animals, whereas &OV0422;rel distribution did not change in treatment animals. Conclusion In oleic acid lung injury, treatment with PFX vapor improves gas exchange by increasing &OV0312;A/&OV0422; heterogeneity in the whole lung without a significant change in gravitational gradient.

[1]  T. Luther,et al.  Perfluorohexane Attenuates Proinflammatory and Procoagulatory Response of Activated Monocytes and Alveolar Macrophages , 2001, Anesthesiology.

[2]  M. Davies,et al.  The effect of perfluorocarbon vapour on the measurement of respiratory tidal volume during partial liquid ventilation , 2000, Physiological measurement.

[3]  R. Glenny,et al.  Validation of fluorescent-labeled microspheres for measurement of relative blood flow in severely injured lungs. , 1999, Journal of applied physiology.

[4]  S. Rasche,et al.  Vaporized perfluorocarbon improves oxygenation and pulmonary function in an ovine model of acute respiratory distress syndrome. , 1999, Anesthesiology.

[5]  A. Rotta,et al.  Partial liquid ventilation influences pulmonary histopathology in an animal model of acute lung injury. , 1999, Journal of critical care.

[6]  A. Aljada,et al.  Liquid ventilation attenuates pulmonary oxidative damage. , 1999, Journal of critical care.

[7]  R. Bartlett,et al.  Partial liquid ventilation in adult patients with ARDS: A multicenter phase I-II trial , 1998 .

[8]  M. Quintel,et al.  Computer tomographic assessment of perfluorocarbon and gas distribution during partial liquid ventilation for acute respiratory failure. , 1998, American journal of respiratory and critical care medicine.

[9]  M. Heine,et al.  Effects of partial liquid ventilation on lung injury in a model of acute respiratory failure: a histologic and morphometric analysis. , 1998, Critical care medicine.

[10]  D. Zurakowski,et al.  Pulmonary blood flow distribution during partial liquid ventilation. , 1998, Journal of applied physiology.

[11]  R. Bartlett,et al.  Partial liquid ventilation in adult patients with ARDS: a multicenter phase I-II trial. Adult PLV Study Group. , 1998, Annals of surgery.

[12]  G. Gildenblat,et al.  Resonant tunneling emitter quantum mechanically coupled to a vacuum gap , 1997 .

[13]  R. Glenny,et al.  Spatial pattern of pulmonary blood flow distribution is stable over days. , 1997, Journal of applied physiology.

[14]  C. Otto,et al.  Initial experience with partial liquid ventilation in adult patients with the acute respiratory distress syndrome. , 1996, JAMA.

[15]  R. Hirschl,et al.  Initial experience with partial liquid ventilation in pediatric patients with the acute respiratory distress syndrome. , 1996, Critical care medicine.

[16]  P. Dandona,et al.  A liquid perfluorochemical decreases the in vitro production of reactive oxygen species by alveolar macrophages. , 1995, Critical care medicine.

[17]  R H Bartlett,et al.  Improvement of gas exchange, pulmonary function, and lung injury with partial liquid ventilation. A study model in a setting of severe respiratory failure. , 1995, Chest.

[18]  J. E. Fisher,et al.  Perfluorocarbon‐associated gas exchange in gastric aspiration , 1994, Critical care medicine.

[19]  M. Lamy,et al.  The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. , 1994, American journal of respiratory and critical care medicine.

[20]  S. Curtis,et al.  Partial liquid breathing with perflubron improves arterial oxygenation in acute canine lung injury. , 1993, Journal of applied physiology.

[21]  N. S. Faithfull,et al.  Comparison of ventilatory support with intratracheal perfluorocarbon administration and conventional mechanical ventilation in animals with acute respiratory failure. , 1993, The American review of respiratory disease.

[22]  N. S. Faithfull,et al.  Intratracheal perfluorocarbon administration combined with mechanical ventilation in experimental respiratory distress syndrome: Dose‐dependent improvement of gas exchange , 1993, Critical care medicine.

[23]  F. Cheney,et al.  Effect of regional alveolar hypoxia on gas exchange in pulmonary edema. , 1992, The American review of respiratory disease.

[24]  F. Cheney,et al.  Effect of regional alveolar hypoxia on gas exchange in dogs. , 1989, Journal of applied physiology.

[25]  R. Moon,et al.  Ventilation-perfusion inequality in normal humans during exercise at sea level and simulated altitude. , 1985, Journal of applied physiology.

[26]  A. Leduc,et al.  A numerical solution of cylindrical coordinate Laplace’s equation with mixed boundary conditions along the axis of symmetry: Application to intracerebral stimulating electrodes , 1984 .

[27]  E. Shaffer,et al.  POSTNATAL MATURATION OF HEPATIC BILE FORMATION IN THE RABBIT , 1984, Pediatric Research.

[28]  P. R. Douglas,et al.  Liquid ventilation: effects on pulmonary function in distressed meconium-stained lambs. , 1984, Pediatric research.

[29]  M. Hlastala.  Multiple inert gas elimination technique. , 1984, Journal of applied physiology: respiratory, environmental and exercise physiology.

[30]  J. W. Evans,et al.  Limits on VA/Q distributions from analysis of experimental inert gas elimination. , 1977, Journal of applied physiology: respiratory, environmental and exercise physiology.

[31]  J B West,et al.  Measurement of continuous distributions of ventilation-perfusion ratios: theory. , 1974, Journal of applied physiology.

[32]  P. Wagner,et al.  Simultaneous measurement of eight foreign gases in blood by gas chromatography. , 1974, Journal of applied physiology.

[33]  A. Olszowka,et al.  A system of digital computer subroutines for blood gas calculations. , 1968, Respiration physiology.