Randomised comparison of partial liquid ventilation, nebulised perfluorocarbon, porcine surfactant, artificial surfactant, and combined treatments on oxygenation, lung mechanics, and survival in rabbits after saline lung lavage

Abstract

Objective: To compare gas exchange, lung mechanics, and survival to 12 h in surfactant-depleted lung-injured rabbits, treated with partial liquid ventilation (PLV) with perfluorocarbon, nebulised perfluorocarbon, and porcine or artificial surfactant. Design: Prospective randomised controlled study. Setting: Animal laboratory, University of Edinburgh, UK. Subjects: Eighty-two adult female New Zealand white rabbits with surfactant deficiency and acute lung injury induced by repeated saline lavage. Interventions: Animals were randomised to one of seven treatments: (a) control (n=20); (b) PLV with perfluorocarbon PF 5080 (n=12); (c) nebulised PF 5080 (n=10); (d) artificial surfactant (n=10); (e) porcine surfactant (n=10); (f) artificial surfactant+PLV (n=10); (g) porcine surfactant+PLV (n=10). Measurements and main results: Arterial blood gases and dynamic compliance (Cdyn) were measured hourly until 12 h. Oxygenation was improved by PLV, porcine surfactant, porcine surfactant+PLV and artificial surfactant+PLV. Cdyn improved after treatment with PLV, porcine surfactant and PLV+porcine surfactant. Survival was greater with PLV and artificial surfactant+PLV. Neither nebulised PF 5080 nor artificial surfactant had a detectable effect. Conclusions: PLV, porcine surfactant and combinations of surfactant with PLV improved oxygenation, Cdyn and survival, but none was clearly superior to the others.