Effect of low-bias flow oscillation with partial liquid ventilation on fluoroscopic image analysis, gas exchange, and lung injury.

Abstract

OBJECTIVE:

To evaluate the effect of low-bias flow oscillation (LBFO) with partial liquid ventilation (PLV) on perfluorochemical evaporation, histopathology, and oxidative tissue damage in an animal model of acute lung injury.

DESIGN:

Prospective, randomized animal study.

SETTING:

Research laboratory of a health sciences university.

SUBJECTS:

Twelve New Zealand White rabbits.

INTERVENTIONS:

Juvenile rabbits were anesthetized, paralyzed, and ventilated through a tracheostomy with either high-frequency oscillatory ventilation or LBFO. Lung injury was induced by repeated saline lavage, after which perflubron was instilled through a side port of the endotracheal tube. Lateral fluoroscopic images were performed at baseline and at various postfill intervals of animals in the high-frequency oscillatory ventilation-PLV and LBFO-PLV groups. The images were digitalized for computer analysis of the Lung Lucency Index, a surrogate marker of perflubron evaporation. Histopathologic evaluation was performed using a lung-injury scoring system. Malondialdehyde was measured in lung homogenates to assess oxidative damage.

MEASUREMENTS AND MAIN RESULTS:

There were no significant differences in gas exchange and ventilator settings between groups throughout the experiment. At 300 mins, the high-frequency oscillatory ventilation-PLV group had a significantly higher Lung Lucency Index compared with the LBFO-PLV group in both dependent and nondependent lung regions (a high Lung Lucency Index correlates with increased perflubron loss). Malondialdehyde measurements were not different between groups. Animals treated with LBFO-PLV had a lower histopathologic lung-injury score compared with high-frequency oscillatory ventilation-PLV.

CONCLUSION:

LBFO-PLV is a viable mode of ventilation in a model of acute lung injury and is associated with significant preservation of perflubron in comparison with high-frequency oscillatory ventilation-PLV. The lower evaporative losses during LBFO-PLV were associated with improved histology scores.

• Authors: Budi Wiryawan, Mark S Dowhy, Bradley P Fuhrman, Alexandre T Rotta
• Journal: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies (Pediatr Crit Care Med) Vol. 6 Issue 6 Pg. 690-7 (Nov 2005) ISSN: 1529-7535 [Print] United States
• PMID: 16276337 (Publication Type: Journal Article)

Chemical References

• Fluorocarbons
• Hydrocarbons, Brominated
• perflubron

Topics

• Animals
• Disease Models, Animal
• Fluorocarbons
• Fluoroscopy
• High-Frequency Ventilation (adverse effects)
• Hydrocarbons, Brominated
• Liquid Ventilation (adverse effects)
• Pulmonary Gas Exchange
• Rabbits
• Random Allocation
• Respiratory Distress Syndrome (blood, etiology, pathology)