High-frequency oscillatory ventilation with partial liquid ventilation in a model of acute respiratory failure.

Abstract

OBJECTIVE:

To determine whether there is an improvement in oxygenation when partial liquid ventilation and high-frequency oscillatory ventilation are combined in the treatment of acute lung injury, compared with high-frequency oscillatory ventilation alone.

DESIGN:

Controlled animal trial.

SETTING:

Research laboratory in a university setting.

SUBJECTS:

Ten 3-kg piglets.

INTERVENTIONS:

Anesthetized piglets underwent high-frequency oscillatory ventilation, with mean airway pressure of 20 cm H2O, before induction of acute lung injury with repeated saline lavage. When PaO2 values were < 100 torr (< 13.3 kPa), five animals were randomized to receive escalating doses (3, 15, and 30 mL/kg) of perflubron at 60-min intervals. The other five animals remained on high-frequency oscillatory ventilation only. Sham dosing was performed at 60-min intervals in these animals. Arterial blood gases were obtained in both groups at baseline, after injury, and after perflubron and sham doses.

MEASUREMENTS AND MAIN RESULTS:

Statistically significant improvements in oxygenation were demonstrated in animals that received 3 mL/kg of perflubron with high-frequency oscillatory ventilation compared with animals receiving high-frequency oscillatory ventilation alone (253 +/- 161 vs. 90 +/- 30 torr [33.65 +/- 21.46 vs. 12.0 +/- 4.0 kPa], p < .05). Improvements in oxygenation with additional administration of perflubron were not greater than the improvements seen in the high-frequency oscillatory ventilation-only group. PaCO2 and pH were similar in both groups at all times. No hemodynamic compromise occurred in either group of animals.

CONCLUSIONS:

The combination of low-dose perflubron with high-frequency oscillatory ventilation leads to more rapid improvement in arterial oxygenation than high-frequency oscillatory ventilation alone, in a piglet model of acute lung injury. Although the group receiving high-frequency oscillatory ventilation alone eventually achieved PaO2 values that were equivalent to the group receiving high-frequency ventilation and perflubron, the combination of perflubron with high-frequency oscillatory ventilation may permit effective oxygenation and ventilation at lower mean airway pressures by facilitating alveolar expansion and decreasing intrapulmonary shunt.

• Authors: H P Baden, J D Mellema, S L Bratton, P P O'Rourke, J C Jackson
• Journal: Critical care medicine (Crit Care Med) Vol. 25 Issue 2 Pg. 299-302 (Feb 1997) ISSN: 0090-3493 [Print] United States
• PMID: 9034268 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Obesity Agents
• Fluorocarbons
• Hydrocarbons, Brominated
• perflubron

Topics

• Analysis of Variance
• Animals
• Anti-Obesity Agents (therapeutic use)
• Blood Gas Analysis
• Fluorocarbons (therapeutic use)
• High-Frequency Ventilation
• Hydrocarbons, Brominated
• Models, Biological
• Respiratory Insufficiency (therapy)
• Swine