Long-term partial liquid ventilation (PLV) with perflubron in the near-term baboon neonate.
OBJECTIVE
The feasibility and safety of continuous long-term (4-5 day) partial liquid ventilation (PLV) using perflubron was demonstrated in newborn baboons. PLV, a potential therapy for adult and neonatal respiratory distress syndrome (RDS), is conventional mechanical ventilation (CMV) with the lung filled to about functional residual capacity with perfluorochemical liquid.


METHODS
As a pilot trial for a larger preclinical study focused on the safety of extended duration PLV, three near term baboons were studied. The animals were delivered by cesarean section, anesthetized, intubated and placed on CMV. The animals were given intratracheal perflubron (30 ml/kg) and maintained on PLV for 96 hours. The transition back to gas ventilation occurred, after draining, over the fifth day (hrs 96-120).


RESULTS
Two of the animals were born with normal pulmonary function, while the third developed respiratory distress prior to PLV. All the animals were adequately supported with PLV using moderate ventilator settings and low concentrations of oxygen. Perflubron distribution was enhanced by periodic rotation of the animals. Preliminary histology show vacuolated alveolar macrophages and no evidence of edema or other significant changes in the lungs. Pulmonary function in the RDS animal, after PLV treatment, showed normal gas exchange and lung mechanics.


CONCLUSIONS
Three near term baboons, one with clinical RDS, tolerated 4 days of PLV followed by 1 day of CMV without complications using practical clinical management methods.
Sekins
K M
KM
Alliance Pharmaceutical Corp., San Diego, CA.
Coalson
J J
JJ
deLemos
R A
RA
Fields
T K
TK
Flaim
S F
SF
Guerra
J M
JM
Hopkins
R M
RM
Jackson
J C
JC
Null
D M
DM
Winter
D C
DC
D000818:Animals; D000831:Animals, Newborn; D004353:Drug Evaluation, Preclinical; D004655:Emulsions; D005466:Fluorocarbons / Q000009:adverse effects / Q000627:therapeutic use*; D005865:Gestational Age; D006842:Hydrocarbons, Brominated; D010215:Papio; D010865:Pilot Projects; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
D004655:Emulsions; D005466:Fluorocarbons; D006842:Hydrocarbons, Brominated; C003072:perflubron