Partial liquid ventilation in critically ill infants receiving extracorporeal life support. Philadelphia Liquid Ventilation Consortium.
OBJECTIVE
To demonstrate that a period of partial liquid ventilation (PLV) with perflubron improves pulmonary function, without adverse events, in a select group of critically ill infants receiving extracorporeal life support (ECLS) with a high likelihood of mortality.


METHODS
This was an open-label, noncontrolled, phase I and II trial of PLV in two infants with congenital diaphragmatic hernia and four infants with acute respiratory distress syndrome (ARDS) who were failing to improve while receiving ECLS. PLV was performed by instilling and maintaining a functional residual capacity of sterile perflubron for 4 to 96 hours.


RESULTS
Four infants were successfully weaned off ECLS for at least 3 days, and two infants (both with ARDS) are long-term survivors after PLV. All infants demonstrated lung recruitment and improved lung compliance, and there were no adverse events related to PLV.


CONCLUSIONS
The study suggests that perflubron PLV is safe, improves lung function, and recruits lung volume in critically ill infants receiving ECLS. PLV therapy for infants with ARDS seems to have a great deal of promise. Based on this and other phase I and II trials, studies of PLV on selected full-term infants before ECLS have been initiated.
Greenspan
J S
JS
Department of Pediatrics, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Fox
W W
WW
Rubenstein
S D
SD
Wolfson
M R
MR
Spinner
S S
SS
Shaffer
T H
TH
D004655:Emulsions / Q000627:therapeutic use; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005466:Fluorocarbons / Q000097:blood / Q000627:therapeutic use*; D006548:Hernia, Diaphragmatic / Q000150:complications / Q000401:mortality / Q000503:physiopathology; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D006842:Hydrocarbons, Brominated; D007223:Infant; D007231:Infant, Newborn; D008020:Life Support Care; D008168:Lung / Q000002:abnormalities; D008170:Lung Compliance; D008297:Male; D010547:Persistent Fetal Circulation Syndrome / Q000209:etiology; D012121:Respiration, Artificial / Q000379:methods*; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*
D004655:Emulsions; D005466:Fluorocarbons; D006842:Hydrocarbons, Brominated; C003072:perflubron