The Science Journal of the American Association for Respiratory Care

1999 OPEN FORUM Abstracts

PARTIAL LIQUID VENTILATION: PHYSIOLOGIC DIFFERENCES BETWEEN FRC AND LOW DOSE AMOUNTS WITH EXOGENOUS SURFACTANT.

Patricia A. Meyers RRT, JM Manaligod MD, EM Bendel-Stenzel MD, DR Bing RRT, SC Simonton MD, MC Mammel MD. Infant Pulmonary Research Center, Children's Hospital-St. Paul, Minnesota and Dept. Of Pediatrics, University of Minnesota, Minneapolis, MN.

Introduction: Does low dose partial liquid ventilation (PLV) with perflubron (LiquiVentÒ) and surfactant (SurvantaÒ; S) provide the same level of improvement in lung injured animals as FRC dose with S. We evaluated physiologic responses in 32 surfactant depleted newborn piglets. Method: 32 newborn piglets were sedated, paralyzed, and ventilated using a volume target of 12cc/kg. We induced lung injury, defined as PaO2<60 torr at FiO2 1.0 and lung compliance reduction by > 30%, with repeated saline lavage. After stabilization on CV (Dräger BabylogÒ), we randomized animals to 4 groups of 8 each: conventional ventilation (CV)+S+PLV to FRC(28.5±5.7 mL/kg), high frequency ventilation (HFV; SensorMedics 3100)+S, HFV+S+low PLV (10 mL/kg) and HFV+S+PLV to FRC(27.5±6.8mL/kg) and ventilated for 20 hrs. PLV animals had perfluorocarbon instilled intratracheally. Evaporative loss were replaced hourly by assessing meniscus in ET tube, HFV+S+low PLV received 3ml/kg/hr replacement. We measured arterial blood gases, arterial and central venous pressures, heart rates, and calculated A/a ratio and OI every hour. Ventilators were adjusted as in clinical use. All techniques provided similar physiologic stability. HFV required higher Paw than CV.

3hr 8hr 12hr 16hr 20hr
CV+S+PLV Paw 14* 13* 13* 12* 12**
pH 7.36 7.37 7.34 7.36 7.35
a/A 0.39 0.42 0.39 0.46 0.44
HFV+S Paw 18 15 15 14? 16
pH 7.36 7.36 7.33 7.34 7.34
a/A 0.41 0.45 .48 0.42 0.43
HFV+S+lowPLV Paw 18 15 15 17 17
pH 7.36 7.36 7.34 7.34 7.38
a/A 0.46 0.44 .52 0.47 0.44
HFV+S+PLV Paw 19 17 16 16 15
pH 7.36 7.39 7.34 7.4 7.37
a/A 0.41 0.46 .40 0.47 0.46
*p<0.05 CMV+S+PLV vs all; **p<0.05 CMV+S+PLV vs HFV+S+low PLV ?p<0.05 HFV+S vs HFV+S+low PLV

Conclusions: Gas exchange and cardiovascular stability was not enhanced by the combination of HFV+PLV. HFV+S+low PLV was not different from other PLV groups.

OF-99-029

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