Effects of Progressive Intratracheal Administration of Perflubron During Conventional Gas Ventilation in Anesthetized Dogs with Oleic Acid Lung Injury
The respiratory distress syndrome of prematurity (RDS) is due to immaturity of alveolar type II cells which fail to produce adequate surfactant. The resultant increase in alveolar surface tension leads to both alveolar flooding and alveolar collapse, decreased compliance, and increased shunt with hypoxemia. Exogenous replacement of surfactant has reduced morbidity and mortality from RDS, though the most premature infants often fail to respond. Another possible therapy for RDS is liquid breathing (LB). Introduced by Kylstra et al. (1962), LB refers to a ventilatory mode in which the lungs are filled with a liquid perfluorocarbon (PFC) or hyperbarically oxygenated saline to functional residual capacity (FRC) followed by tidal ventilation with additional liquid. Using PFC’s with surface tensions of ≈ 15 dynes/cm, Shaffer et al. (1983a, 1983b) showed markedly improved arterial oxygenation during LB compared to gas ventilation in surfactant-deficient, very premature lambs. Interestingly, even after drainage of PFC from the lungs of these lambs, persistent improvements in FRC, compliance, and gas exchange were seen, suggesting that residual PFC coating the alveoli improved alveolar surface tension.
KeywordsOleic Acid Pulmonary Capillary Wedge Pressure Functional Residual Capacity Pulmonary Blood Flow Lung Lavage
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- Kylstra, J.A. and Schoenfish, W.H., 1972, Alveolar surface tension in fluorocarbon-filled lungs, J. Appl. Physiol. 33:32.Google Scholar
- Lachman, B., 1989, Animal models and clinical pilot studies of surfactant replacement in adult respiratory distress syndrome, Eur. Respir. J. 2:98S.Google Scholar
- Lowe, C.A., and Shaffer, T.H., 1986, Pulmonary vascular resistance in the fluorocarbon-filled lung, J. Appl. Physiol. 60:154.Google Scholar
- Richman, P.S., Spragg, R.G., Merritt, T.A., and Curstedt, T., 1989, The adult respirtory distress syndrome: first trials with surfactant replacement, Eur. Respir. J. 2:1095.Google Scholar
- Richman, P.S., Wolfson, M.R., Shaffer, T.H., and Kelsen, S.G., 1990, Lung lavage with oxygenated fluorocarbon improves gas exchange and lung compliance in cats with acute lung injury, Am. Rev. Respir. Dis. 141:A773.Google Scholar
- Rogers, R.M., Braunstein, M.S., and Shuman, J.F., 1972, Role of bronchopulmonary lavage in the treatment of respiratory failure: a review, Chest 62:95.Google Scholar
- West, J.B., Dollery, C.T., Matthews, C.M.E., and Zardini, P., 1965, Distribution of blood flow and ventilation in saline-filled lung, J. Appl. Physiol. 20:1107.Google Scholar