Am. J. Respir. Crit. Care Med.,
Volume 162, Number 4, October 2000, 1372-1376
Accuracy of Hemodynamic Measurements during
Partial Liquid Ventilation with Perflubron
HENRY E.
FESSLER
and
DAVID
PEARSE
Pulmonary and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland
Patients undergoing partial liquid ventilation (PLV) are often monitored with pulmonary artery catheters and receive positive end-expiratory pressure (PEEP). PEEP can dissociate wedge pressure (Pcw) from transmural left atrial pressure (Platm) by elevating pleural pressure and can dissociate Pcw from Pla by elevating alveolar pressure, PLV, like PEEP, also elevates pleural and alveolar pressures. However, the artifacts PLV may cause in measured vascular pressures are unknown. In 6 anesthetized, paralyzed healthy
adult sheep, we compared effects of gas ventilation (GV) and PLV
with 10 and 30 ml/kg perflubron on pericardial pressure (Pperi),
Pcw, Pla, thermodilution cardiac output, and pulmonary artery
flow measured with a doppler probe. PEEP was applied from 0-15
mm Hg during GV and PLV. PLV changed pericardial pressure or
cardiac output minimally (at PEEP0, GV: Pperi = 
1.7 ± 0.6 mm
Hg, CO = 3.2 ± 0.1 L/m; 10 ml/kg perflubron: Pperi = 1.3 ± 0.6 mm Hg, CO = 3.4 ± 0.2 L/m; 30 ml/kg perflubron: Pperi = 1.6 ± 0.7 mm Hg, CO = 3.4 ± 0.2 L/m; all mean ± SEM). On PEEP, Pcw
agreed with Pla and Platm as well or better during PLV as during
gas ventilation. Cardiac output by thermodilution and probe agreed
equally well under all conditions. We conclude that hemodynamic
values are as accurate during PLV as during gas ventilation.
