Liquid ventilation of human preterm neonates.
This report details the application of liquid perfluorochemical ventilation for investigational therapy in three human preterm neonates (gestational ages 28, 24, and 23 weeks) in whom conventional therapies for severe respiratory distress had failed. Liquid ventilation was performed without difficulty in each infant for two 3- to 5-minute cycles by means of gravity-assisted technique. Marked improvement in lung distensibility, without a change in cardiovascular status, occurred in all three infants after liquid ventilation; oxygenation improved in two. All infants died within 19 hours of liquid ventilation, and there was no evidence of retained perfluorochemical fluid in the lungs or pleural space. Death was probably related to the severity of lung disease before the initiation of liquid ventilation. This satisfactory initial outcome shows the feasibility and potential of this treatment of pulmonary dysfunction in the preterm neonate.
Greenspan
J S
JS
Department of Physiology, Temple University School of Medicine, Philadelphia, Pennsylvania.
Wolfson
M R
MR
Rubenstein
S D
SD
Shaffer
T H
TH
D000403:Airway Resistance; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000097:blood; D005466:Fluorocarbons / Q000008:administration & dosage*; D006339:Heart Rate; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007442:Intubation, Intratracheal; D008170:Lung Compliance; D010100:Oxygen / Q000008:administration & dosage* / Q000097:blood; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D012121:Respiration, Artificial / Q000379:methods*; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D013990:Tidal Volume; D013997:Time Factors
D005466:Fluorocarbons; D006454:Hemoglobins; D002245:Carbon Dioxide; D010100:Oxygen