Published ahead of print on September 4, 2003, doi:10.1164/rccm.200206-527OC Am. J. Respir. Crit. Care Med., Volume 168, Number 11, December 2003, 1378-1382 A more recent version of this article appeared on December 1, 2003
Submitted on June 7, 2002 Dose-response effect of perfluorocarbon administration on lung microvascular permeability in ratsJean-Damien Ricard1,1 Hopital Louis Mourier (Assistance Publique - Hopitaux de Paris), Service de Reanimation Medicale, Colombes, France; IFR02 Claude Bernard, EA 3512, Institut National de la Sante et de la Recherche Medicale, Faculte de Medecine Xavier Bichat, Paris, France, 2 Hopital Bichat (Assistance Publique - Hopitaux de Paris), Service de Radiologie, Paris, France, 3 IFR02 Claude Bernard, EA 3512, Institut National de la Sante et de la Recherche Medicale, Faculte de Medecine Xavier Bichat, Paris, France * To whom correspondence should be addressed. E-mail: saumon{at}bichat.inserm.fr.
The effect of different perflubron doses on overdistension lung injury was evaluated. Rats were given 0 (controls) to 20 ml/kg perflubron and ventilated with 33 ml/kg VT without or with 5 cm H2O positive end-expiratory pressure (PEEP). Large (20 ml/kg), but not lower perflubron doses, aggravated lung capillary leak in the absence of PEEP. PEEP application aggravated capillary leak in controls, had no effect in those given a low (10 ml/kg) dose, but decreased the leak in rats ventilated with a large dose compared with ZEEP. In the presence of PEEP, this low dose decreased capillary leak compared to controls or rats given the large dose. Lung CT scans showed that the large dose increased functional residual capacity by 68% and produced gas trapping that was reduced by PEEP. Thus, large doses predispose to overdistension injury whereas low doses do not and may even have a protective effect in the presence of PEEP. The paradoxical beneficial effect of PEEP when large doses are given may be due to gas trapping reduction. These findings confirm that liquid ventilation does not aggravate volutrauma provided perflubron doses are adjusted. They provide a lead to further investigate partial liquid ventilation in the clinical setting. Key words: Ventilator-induced lung injury, Partial liquid ventilation, ARDS, CT scan.
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