Total liquid ventilation with perfluorocarbons increases pulmonary end-expiratory volume and compliance in the setting of lung atelectasis

Critical Care Medicine
R TooleyR H Bartlett

Abstract

To compare compliance and end-expiratory lung volume during reexpansion of normal and surfactant-deficient ex vivo atelectatic lungs with either gas or total liquid ventilation. Controlled, animal study using an ex vivo lung preparation. A research laboratory at a university medical center. Thirty-six adult cats, weighing 2.5 to 4.0 kg. Heparin (300 U/kg) was administered, cats were killed, and lungs were excised en bloc. Normal lungs and saline-lavaged, surfactant-deficient lungs were allowed to passively collapse and remain atelectatic for 1 hr. Lungs then were placed in a plethysmograph and ventilated for 2 hrs with standardized volumes of either room air or perfluorocarbon. Static pulmonary compliance and end-expiratory lung volume were measured every 30 mins. Reexpansion of normal atelectatic lungs with total liquid ventilation was associated with an 11-fold increase in end-expiratory lung volume when compared with the increase in end-expiratory lung volume observed with gas ventilation (total liquid ventilation 50 +/- 14 mL, gas ventilation 4 +/- 9 mL, p < .0001). The difference was even more pronounced in the surfactant-deficient lungs with an approximately 19-fold increase in end-expiratory lung volume observed in the t...Continue Reading

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