Perfluorocarbon-associated gas exchange (partial liquid ventilation) in respiratory distress syndrome A prospective, randomized, controlled study

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Abstract
To determine the efficacy of perfluorocarbon-associated gas exchange (partial liquid ventilation) in respiratory distress syndrome. Prospective, randomized, controlled study. State University of New York at Buffalo, School of Medicine and Biomedical Sciences. Eleven premature lambs with respiratory distress syndrome, delivered by cesarean section. Five lambs were supported by conventional mechanical ventilation alone. Six lambs were switched to perfluorocarbon-associated gas exchange after 60 to 90 mins of conventional mechanical ventilation. Perfluorocarbon-associated gas exchange was accomplished by instilling a volume of liquid perfluorocarbon equivalent to normal functional residual capacity (30 mL/kg) into the trachea, performing 3 to 4 mins of tidal liquid ventilation, and at end-expiration, with liquid functional residual capacity of 30 mL/kg remaining in the lung, reconnecting the animal to the volume ventilator for gas tidal volumes. Serial arterial blood gases and lung mechanics were measured. While receiving conventional ventilation, all animals developed progresssive hypoxemia, hypercarbia, and acidosis. However, in the perfluorocarbon-associated gas exchange group, within 5 mins of the initiation of perfluorocarbon-associated gas exchange, mean Pao2 increased four-fold, from 59 ± 6 torr (7.9 ± 0.8 kPa) during conventional ventilation to 250 ± 28 torr (33.3 ± 3.7 kPa; pConclusionsWe conclude that perfluorocarbon-associated gas exchange, which employs liquid functional residual capacity and gas tidal volumes delivered by a conventional ventilator can facilitate oxygenation and CO2 removal, and dramatically improve lung mechanics in the premature lamb with respiratory distress syndrome. (Cirt Care Med 1993; 21:1270–1278)

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