The Science Journal of the American Association for Respiratory Care

1998 OPEN FORUM Abstracts

HIGH STRETCH LUNG INJURY DOES OCCUR DURING BOTH GAS AND PARTIAL LIQUID VENTILATION IN HEALTHY SHEEP

Yuji Fujino MD, Max Kirmse MD, Jean-Daniel Chiche MD, Jonathan Hromi BA, Robert M. Kacmarek PhD RRT. Anesthesia and Respiratory Care, Massachusetts General Hospital and Harvard Medical School, Boston MA

Partial liquid ventilation (PLV) was introduced by Fuhrman et al. and has been shown to be effective in improving gas exchange in animal models and patients with IRDS. The aim of this study was to investigate the effect of high tidal volume ventilation with the same end inspiratory plateau pressure (P_{PLAT}) on gas exchange and lung mechanics of normal sheep lungs during GV and PLV.

Methods. Sixteen fasted Hampshire sheep (28.4┬▒3.9 kg body weight) were investigated. Following baseline measurements the animals were randomly assigned to the following 4 groups: Group GV-L (n=4): gas ventilation with normal tidal volume (12mL/kg) and PEEP 5cmH_{2}O. Group GV-H (n=4): gas ventilation with high tidal volume (target P_{PLAT} = 50cmH_{2}O) and PEEP 5cmH_{2}O. Group PLV-L (n=4): partial liquid ventilation with normal tidal volume (12mL/kg) and PEEP set 1cmH_{2}O above the lower inflection point on the pressure volume curve. Group PLV-H (n=4): partial liquid ventilation with high tidal volume (target P_{PLAT} = 50cmH_{2}O) and PEEP 5cmH_{2}O. Following 5 hours of ventilation animals were sacrificed and histological examination were performed. Results.

Group Survival Non-survival Bulla Pneumothorax

PLV-H (n=4) 1 3* 1* 1*

PLV-L (n=4) 4 0 0 0

GV-H (n=4) 3 1 3 3

GV-L (n=4) 4 0 0 0

* [chi]^{2} p < 0.05 vs. GV-H

(See original for figure)

Histological examination showed severe lung injury during high volume ventilation with both GV and PLV.

Conclusion. The use of PLV does not protect the lungs of healthy sheep from the ventilator induced lung injury observed with high stretch ventilation.

This abstract is funded in part by Alliance Pharmaceutical Corp. and Hoechst Marion Roussel Inc.

The 44th International Respiratory Congress Abstracts-On-Disk®, November 7 - 10, 1998, Atlanta, Georgia.

You are here: RCJournal.com » Past OPEN FORUM Abstracts » 1998 Abstracts » HIGH STRETCH LUNG INJURY DOES OCCUR DURING BOTH GAS AND PARTIAL LIQUID VENTILATION IN HEALTHY SHEEP