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Vol. 84, Issue 1, 327-334, January 1998
Divisions of 1 Neonatology and
2 Critical Care,
Sukumar, Minakshi, Mahesh Bommaraju, John E. Fisher,
Frederick C. Morin III, Michele C. Papo, Bradley P. Fuhrman, Lynn J. Hernan, and Corinne Lowe Leach. High-frequency partial liquid
ventilation in respiratory distress syndrome: hemodynamics and gas
exchange. J. Appl. Physiol. 84(1):
327-334, 1998.
Partial liquid ventilation using conventional
ventilatory schemes improves lung function in animal models of
respiratory failure. We examined the feasibility of high-frequency
partial liquid ventilation in the preterm lamb with respiratory
distress syndrome and evaluated its effect on pulmonary and systemic
hemodynamics. Seventeen lambs were studied in three groups:
high-frequency gas ventilation (Gas group), high-frequency partial
liquid ventilation (Liquid group), and high-frequency partial liquid
ventilation with hypoxia-hypercarbia (Liquid-Hypoxia
group). High-frequency partial liquid ventilation increased oxygenation compared with high-frequency gas ventilation over
5 h (arterial oxygen tension 253 ± 21.3 vs. 17 ± 1.8 Torr; P < 0.001).
Pulmonary vascular resistance decreased 78%
(P < 0.001), pulmonary blood flow
increased fivefold (P < 0.001), and
aortic pressure was maintained (P < 0.01) in the Liquid group, in contrast to progressive hypoxemia,
hypercarbia, and shock in the Gas group. Central venous
pressure did not change. The Liquid-Hypoxia group was similar to
the Gas group. We conclude that high-frequency partial liquid
ventilation improves gas exchange and stabilizes pulmonary and systemic
hemodynamics compared with high-frequency gas ventilation. The
stabilization appears to be due in large part to improvement in gas
exchange.
perfluorocarbon; pulmonary vascular resistance; mechanical ventilation; respiratory failure; prematurity
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