Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-19T11:32:03.606Z Has data issue: false hasContentIssue false
  • English
  • Français

Partial liquid ventilation in acute salt water-induced lung injury

Published online by Cambridge University Press:  29 June 2005

P. Schober ,
D. Seidel ,
R. Kalb ,
D. Obal ,
M. A. Pakulla  and
S. A. Loer
P. Schober
Affiliation:
University of Düsseldorf, Department of Anaesthesiology, Düsseldorf, Germany
D. Seidel
Affiliation:
University of Düsseldorf, Department of Anaesthesiology, Düsseldorf, Germany
R. Kalb
Affiliation:
University of Düsseldorf, Department of Anaesthesiology, Düsseldorf, Germany
D. Obal
Affiliation:
University of Düsseldorf, Department of Anaesthesiology, Düsseldorf, Germany
M. A. Pakulla
Affiliation:
University of Düsseldorf, Department of Anaesthesiology, Düsseldorf, Germany
S. A. Loer
Affiliation:
University of Düsseldorf, Department of Anaesthesiology, Düsseldorf, Germany
Get access

Extract

Summary

Background and objectives: Salt-water aspiration results in pulmonary oedema and hypoxia. We tested the hypothesis that partial liquid ventilation has beneficial effects on gas exchange and rate of survival in acute and extended salt water-induced lung injury. Methods: Anaesthetized, ventilated rats (tidal volume 6 mL kg−1, PEEP 5 cmH2O) received a tracheal salt-water instillation (3%, 8 mL kg−1 body weight) and were randomly assigned to three groups (n = 10 per group). While lungs of Group 1 were gas-ventilated, lungs of Group 2 received a single perfluorocarbon instillation (30 min after the injury, 5 mL kg−1 perfluorocarbon) and lungs of Group 3 received an additional continuous perfluorocarbon application into the treachea (5 mL kg−1 h−1). Arterial blood gases were measured with an intravascular blood gas sensor. Results: Salt-water instillation resulted in a marked decrease in PaO2 values within 30 min (from 432 ± 65 to 83 ± 40 mmHg, FiO2 = 1.0, P < 0.01). Arterial oxygenation improved in all three groups irrespective of treatment. We observed no significant differences between groups in peak PaO2 and PaCO2 values. Conclusions: Our results suggest that partial liquid ventilation has no additional beneficial effects on gas exchange after life-threatening salt water-induced lung injury when compared to conventional gas ventilation with positive end-expiratory pressure.

Keywords

ACUTE RESPIRATORY DISTRESS SYNDROMELIQUID VENTILATION ratsWATER, saltPNEUMONIA, aspiration
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 7 , July 2005 , pp. 536 - 540
Copyright
© 2005 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Folkesson HG, Kheradmand F, Matthay MA. The effect of salt water on alveolar epithelial barrier function. Am J Respir Crit Care Med 1994; 150: 1555–1563.Google Scholar
Cohen DS, Matthay MA, Cogan MG, Murray JF. Pulmonary edema associated with salt water near-drowning: new insights. Am Rev Respir Dis 1992; 146: 794–796.Google Scholar
Modell JH, Moya F, Williams HD, Weibley TC. Changes in blood gases and A-aDO2 during near-drowning. Anesthesiology 1968; 29: 456–465.Google Scholar
Leach CL, Greenspan JS, Rubenstein SD et al. Partial liquid ventilation with perflubron in premature infants with severe respiratory distress syndrome. The LiquiVent Study Group. New Engl J Med 1996; 12: 761–767.Google Scholar
Hernan LJ, Fuhrman BP, Kaiser RE et al. Perfluorocarbon-associated gas exchange in normal and acid-injured large sheep. Crit Care Med 1996; 24: 475–481.Google Scholar
Nesti FD, Fuhrman BP, Steinhorn DM et al. Perfluorocarbon-associated gas exchange in gastric aspiration. Crit Care Med 1994; 22: 1445–1452.Google Scholar
Loer SA, Tarnow J. Partial liquid ventilation reduces fluid filtration of isolated rabbit lungs with acute hydrochloric acid-induced edema. Anesthesiology 2000; 94: 1045–1049.Google Scholar
Frank JA, Gutierrez JA, Jones KD, Allen L, Dobbs L, Matthay MA. Low tidal volume reduces epithelial and endothelial injury in acid-injured rat lungs. Am J Respir Crit Care Med 2002; 165: 242–249.Google Scholar
Loer SA, Kindgen-Milles T. Partial liquid ventilation: partial liquid ventilation: effects of liquid volume and ventilatory settings on perfluorocarbon evaporation. Eur Respir J 2002; 20: 1499–1504.Google Scholar
Loer SA, Scharte LA, Pakulla M, Picker O, Scheeren TWL. Partial liquid ventilation – effects of positive end expiratory pressure on perfluorocarbon evaporation from the lungs of anaesthetized dogs. Intens Care Med 2003; 29: 467–470.Google Scholar
Pakulla MA, Obal D, Loer SA. Continuous intra- arterial blood gas monitoring in rats. Lab Animal 2004; 38: 133–137.Google Scholar
Pakulla MA, Obal D, Seidel D, Loer SA. Hydrochloric acid-induced lung injury – effects of early partial liquid ventilation on gas exchange and survival. Intens Care Med 2004; 29: 467–470.Google Scholar
Loer SA, Tarnow J. Effects of partial liquid ventilation with perfluorocarbons on pressure–flow relationships, vascular compliance, and filtration coefficients of isolated blood- perfused rabbit lungs. Crit Care Med 1998; 26: 2037–2041.Google Scholar
Calderwood HW, Modell JH, Ruiz BC, Brogdon JE, Hood CI. Pulmonary lavage with liquid fluorocarbon in a model of pulmonary edema. Anesthesiology 1973; 38: 141–144.Google Scholar
Mikawa K, Nishina K, Takao Y, Obara H. Efficacy of partial liquid ventilation in improving acute lung injury induced by intratracheal acidified infant formula: determination of optimal dose and positive end-expiratory pressure level. Crit Care Med 2004; 32: 209–216.Google Scholar