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Am. J. Respir. Crit. Care Med., Volume 164, Number 1, July 2001, 31-35

Persistent Improvement of Gas Exchange and Lung Mechanics by Aerosolized Perfluorocarbon

MICHAEL A. KANDLER, KATHARINA von der HARDT, ELLEN SCHOOF, JÖRG DÖTSCH, and WOLFGANG RASCHER

Klinik für Kinder und Jugendliche der Friedrich-Alexander-Universität, Erlangen-Nürnberg, Germany

The effect of aerosolized perfluorocarbon (PFC) (FC77) on pulmonary gas exchange and lung mechanics was studied in a surfactant depleted piglet model. Sixty minutes after induction of lung injury by bronchoalveolar lavage, 20 piglets were randomized to receive aerosolized PFC (Aerosol-PFC, 10 ml/kg/h, n = 5), partial liquid ventilation (PLV) at FRC capacity volume (FRC-PLV, 30 ml/kg, n = 5) or low volume (LV-PLV, 10 ml/kg/h, n = 5), or intermittent mandatory ventilation (IMV) (Control, n = 5). After 2 h, perfluorocarbon application was stopped and IMV was continued for 6 h. Sixty minutes after the onset of therapy, PaO2 was significantly higher and PaCO2 was significantly lower in the Aerosol-PFC and the FRC-PLV groups than in the LV-PLV and the Control groups; p < 0.001. Six hours after treatment, maximum PaO2 was found in the Aerosol-PFC group: 406.4 ± 26.9 mm Hg, FRC-PLV: 217.3 ± 50.5 mm Hg, LV-PLV: 96.3 ± 18.9 mm Hg, Control: 67.6 ± 8.4 mm Hg; p < 0.001. PaCO2 was lowest in the Aerosol-PFC group: 24.2 ± 1.7 mm Hg, FRC-PLV: 35.9 ± 2.8 mm Hg, LV-PLV: 56.7 ± 12.4 mm Hg, Control: 60.6 ± 5.1 mm Hg; p < 0.01. Dynamic compliance (C20/c) was highest in the Aerosol-PFC group; p < 0.01. Aerosolized perfluorocarbon improved pulmonary gas exchange and lung mechanics as effectively as PLV did in surfactant-depleted piglets, and the improvement was sustained longer.




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