help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Published ahead of print on October 27, 2005, doi:10.1164/rccm.200508-1196OC
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Online Supplement
Right arrow All Versions of this Article:
200508-1196OCv1
173/8/882    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kacmarek, R. M.
Right arrow Articles by Slutsky, A. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kacmarek, R. M.
Right arrow Articles by Slutsky, A. S.
American Journal of Respiratory and Critical Care Medicine Vol 173. pp. 882-889, (2006)
© 2006 American Thoracic Society
doi: 10.1164/rccm.200508-1196OC

Original Article

Partial Liquid Ventilation in Adult Patients with Acute Respiratory Distress Syndrome

Robert M. Kacmarek, Herbert P. Wiedemann, Philip T. Lavin, Mark K. Wedel, Ahmet S. Tütüncü and Arthur S. Slutsky

Department of Anesthesia and Critical Care, Harvard Medical School, and Respiratory Care, Massachusetts General Hospital, Boston; Averion, Inc.; Boston Biostatistics Research Foundation, Inc., Framingham, Massachusetts; Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Foundation, Cleveland, Ohio; Clinical Research Alliance Pharmaceutical Corporation, San Diego, California; and St. Michael's Hospital, and Departments of Medicine, Surgery, and Biomedical Engineering, University of Toronto, Toronto, Canada

Correspondence and requests for reprints should be addressed to Robert M. Kacmarek, Ph.D., R.R.T., Respiratory Care, Ellison 401, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail: rkacmarek{at}partners.org

Rationale: Despite recent clinical trials demonstrating improved outcome in acute respiratory distress syndrome (ARDS), mortality remains high. Partial liquid ventilation (PLV) using perfluorocarbons has been shown to improve oxygenation and decrease lung injury in various animal models.

Objective: To determine if PLV would have an impact on outcome in patients with ARDS.

Methods: Patients with ARDS were randomized to (1) conventional mechanical ventilation (CMV; n = 107), (2) "low-dose" perfluorocarbon (10 ml/kg; n = 99), and (3) "high-dose" perfluorocarbon (20 ml/kg; n = 105). Patients in all three groups were ventilated using volume ventilation, VT <= 10 ml/kg predicted body weight, rate <= 25/min, inspiratory-to-expiratory ratio <= 1:1, FIO2 >= 0.5, and positive end-expiratory pressure >= 13 cm H2O.

Results: The 28-d mortality in the CMV group was 15%, versus 26.3% in the low-dose (p = 0.06) and 19.1% in the high-dose (p = 0.39) PLV groups. There were more ventilator-free days in the CMV group (13.0 ± 9.3) compared with both the low-dose (7.4 ± 8.5; p < 0.001) and high-dose (9.9 ± 9.1; p = 0.043) groups. There were more pneumothoraces, hypoxic episodes, and hypotensive episodes in the PLV patients.

Conclusions: PLV at both high and low doses did not improve outcome in ARDS compared with CMV and cannot be recommended for patients with ARDS.

Key Words: acute respiratory distress syndrome • liquid ventilation • mechanical ventilation • partial liquid ventilation




This article has been cited by other articles:


Home page
 Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
D. Haufe, E. Koenigshausen, L. Knels, M. Wendel, S. N. Stehr, and T. Koch
Leukocyte antibacterial functions are not impaired by perfluorocarbon exposure in vitro
Am J Physiol Lung Cell Mol Physiol, July 1, 2008; 295(1): L134 - L142.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
R. Agarwal, R. Srinivas, A. Nath, and S. K. Jindal
Is the Mortality Higher in the Pulmonary vs the Extrapulmonary ARDS?: A Metaanalysis
Chest, June 1, 2008; 133(6): 1463 - 1473.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
W. Burkhardt, P. Koehne, H. Wissel, S. Graf, H. Proquitte, R. R. Wauer, and M. Rudiger
Intratracheal perfluorocarbons diminish LPS-induced increase in systemic TNF-{alpha}
Am J Physiol Lung Cell Mol Physiol, June 1, 2008; 294(6): L1043 - L1048.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. Zambon and J.-L. Vincent
Mortality Rates for Patients With Acute Lung Injury/ARDS Have Decreased Over Time
Chest, May 1, 2008; 133(5): 1120 - 1127.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
R. M. Muellenbach, C. Wunder, J. Brederlau, J. Villar, A. T. Rotta, S. Maruvada, G. Vento, M. Tana, C. Tirone, V. Vendettuoli, et al.
High-frequency ventilation is/is not the optimal physiological approach to ventilate ARDS patients.
J Appl Physiol, April 1, 2008; 104(4): 1236 - 1237.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. Villar, L. Perez-Mendez, J. Lopez, J. Belda, J. Blanco, I. Saralegui, F. Suarez-Sipmann, J. Lopez, S. Lubillo, R. M. Kacmarek, et al.
An Early PEEP/FIO2 Trial Identifies Different Degrees of Lung Injury in Patients with Acute Respiratory Distress Syndrome
Am. J. Respir. Crit. Care Med., October 15, 2007; 176(8): 795 - 804.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
A. Malhotra
Low-Tidal-Volume Ventilation in the Acute Respiratory Distress Syndrome
N. Engl. J. Med., September 13, 2007; 357(11): 1113 - 1120.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
E. B. Milbrandt, A. Ishizaka, and D. C. Angus
Update in Critical Care 2006
Am. J. Respir. Crit. Care Med., April 1, 2007; 175(7): 638 - 648.
[Full Text] [PDF]

Home page
 ChestHome page
T. D. Girard and G. R. Bernard
Mechanical Ventilation in ARDS: A State-of-the-Art Review
Chest, March 1, 2007; 131(3): 921 - 929.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
W. Y.W. Lew
A Cool Heart Protected From Infarction: Clinical Translation of Breathing Chilled Liquids
J. Am. Coll. Cardiol., February 6, 2007; 49(5): 606 - 607.
[Full Text] [PDF]

Home page
 Evid. Based Med.Home page
Other articles noted
Evid. Based Med., February 1, 2007; 12(1): 31 - 32.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. Sindelar, E. Rieger-Fackeldey, G. Sedin, and A. Jonzon
A Pressure Increase Due to Hydrostatic Pressure of Perfluorocarbon Is Not Obvious as Sensed by Pulmonary Stretch Receptors
Am. J. Respir. Crit. Care Med., February 1, 2007; 175(3): 290 - 290.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. M. Kacmarek and A. S. Slutsky

Am. J. Respir. Crit. Care Med., February 1, 2007; 175(3): 290a - 291.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. L. J. Degraeuwe and L. J. I. Zimmermann
Why Partial Liquid Ventilation Did Not Fulfill Its Promise
Am. J. Respir. Crit. Care Med., September 1, 2006; 174(5): 615 - 615.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. M. Kacmarek and A. S. Slutsky
Why Partial Liquid Ventilation Did Not Fulfill Its Promise
Am. J. Respir. Crit. Care Med., September 1, 2006; 174(5): 615a - 616.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. M. Kacmarek and A. S. Slutsky
Negative Studies Deserve More Attention
Am. J. Respir. Crit. Care Med., June 15, 2006; 173(12): 1415 - 1415.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. G. de Abreu
Negative studies deserve more attention.
Am. J. Respir. Crit. Care Med., June 15, 2006; 173(12): 1414a - 11415.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
W. M. Roemer, S. Gentzsch, and H. Andel
Pressure increase due to hydrostatic pressure of perfluorocarbon.
Am. J. Respir. Crit. Care Med., May 1, 2006; 173(9): 1046 - 1046.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. M. Kacmarek and A. S. Slutsky
Pressure Increase Due to Hydrostatic Pressure of Perfluorocarbon
Am. J. Respir. Crit. Care Med., May 1, 2006; 173(9): 1046a - 1047.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2006 American Thoracic Society