The Effect Of Partial Liquid Ventilation On Gas Exchange And Hemodynamics In Acute Lung Injury

Objective:To investigate the effect of partial liquid ventilation ( PLV ) with perfluorocarbons (PFC) on gas exchange and hemodynamics in piglets of acute lung injury (ALI) . Mothods:16 female healthy piglets weighting 25-30 kg were randomly divided into control group (n=8) and PLV group (n=8). The animals were tracheotomized and mechanically ventilated with oxygen (FiO2=1.0). At that time point the parameters of gas exchange and hemodynamics were measured as Baseline. Acute lung injury(ALI) were induced by lung lavage according to Lachmann,. All piglets were surfactant-depleted by lung lavage using 37℃, 40ml/kg of 9g/L NaCl until PaO2<100mmHg for one hour. Conventional mechanical ventilaton (CMV) was administered in control group; PLV group received doses of 30ml/kg FC-77 and were administered the respiratory parameters as the control group for four hours. FC-77 was continued dropping via tracheal tube to surport the evaporation of FC-77 during therapy. The parameters of gas exchange and hemodynamics were measuredafter ALI(1h,2h,3h,4h) in two groups. Results:PaO2 in control group significantly decreased from (492 ± 68) mmHg in Baselineto (77±11) mmHg in ALI (P<0.01), it showed surfactant-depletion by lung lavage induced a stable ALI model. AaDO2 in control group significantly increased from (114 ± 35) mmHg in Baseline to (575 ± 26) mmHg in ALI (P<0.01). Intrapulmonary shunt (Qs/Qt) in control group significantly increased from (12 ± 6) % in Baseline to (48 ± 12) % in ALI (P<0.01); Mean pulmonary artery (MPAP) in control group significantly increased than Baseline (P<0.01).After PFC instillation one hour PaO2 in PLV group significantly increased from(76 ± 10) mmHg in ALI to (203 ± 101) mmHg and increased to (262 ± 50) mmHg after PFC instillation four hours and significantly higher than in control group (P<0.01); After PFC instillation one hour AaDO2 in PLV group significantly decreased from (592 ± 21) mmHg in ALI to (456 ± 54) mmHg and significantly lower than in control group; Qs/Qt in PLV group significantly decreased from (57 ± 8)% in ALI to (41 ± 10)% after PFC instillation one hour and decreased to (28 ± 6)% after PFC instillation four hours and was significantly lower than in control group (P<0.01); MPAM, PCWP and other hemodynamics had no significantly different comparing with control group. Conculation:PLV with PFC can improve arterial oxygenation and decrease QS/Qt in piglets of ALI by lung lavage without adverse effect on hemodynamics; PLV can't decreases pulmonary hypertension inducing by ALI.