Long-term effect of perfluorocarbon distension on the lung.
OBJECTIVE
We have demonstrated previously that postnatal lung growth can be accelerated by continuous intrapulmonary distension with perfluorocarbon (PFC). The purpose of this study was to examine the effect of PFC distension on long-term lung function and to determine if shorter periods of lung distension would be sufficient to stimulate growth.


METHODS
Eight neonatal lambs underwent a right thoracotomy. The superior segment of the right upper lobe of the experimental group (n = 5) was isolated and distended with PFC to an intrabronchial pressure of 7 to 10 mm Hg. The inferior segment was removed. After a 7-day distension period (the maximum period of exposure currently allowed for humans), the experimental animals underwent removal of the intrabronchial catheter and surgical closure of the bronchial stump. Control animals (n = 3) underwent right upper lobe inferior segmentectomy alone. Animals were allowed to breathe spontaneously and reach 3 to 6 months of age. Before death, all animals were evaluated by chest radiographs and ventilation-perfusion scans. Pulmonary venous blood gas levels were obtained. Lungs were harvested and airway fixed for morphometric analysis.


RESULTS
Chest radiographs of the experimental group showed variable amounts of intrapleural and interstitial PFC but were otherwise normal. Results of ventilation/perfusion (VQ) scans of all experimental animals were normal. On retrieval, the right upper lobe of experimental animals appeared slightly hyperinflated compared with controls. Right upper lobe pulmonary vein PaO2 to left pulmonary vein PaO2 ratio was comparable in experimental and control animals (1.2 +/- .41 v 0.92 +/- .15). DNA to protein ratios were slightly higher in the right upper lobes of experimental animals, however, the difference was not statistically significant (.64 +/- .11 v .42 +/- .03). On histological evaluation, the airway epithelium and alveoli of the right upper lobe of experimental animals appeared normal. Lung morphometry results showed no statistically significant differences in alveolar number between experimental and control animals.


CONCLUSIONS
From these preliminary data we conclude that (1) lung architecture is preserved in juvenile animals subjected to intrapulmonary PFC distension as neonates, (2) lung function is preserved in the lobar segment after PFC distension, and (3) intrapulmonary PFC distension appears to be safe at 3 to 6 months follow-up. However, 7 days of PFC distension is insufficient to promote lung growth.
Department of Surgery, Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
K K
KK
Nobuhara
M L
ML
Ferretti
A M
AM
Siddiqui
S S
SS
Kim
S T
ST
Treves
J M
JM
Wilson
D000818:Animals; D000831:Animals, Newborn; D005466:Fluorocarbons / Q000008:administration & dosage* / Q000627:therapeutic use; D065630:Hernias, Diaphragmatic, Congenital; D008168:Lung / Q000187:drug effects* / Q000254:growth & development*; D011650:Pulmonary Alveoli / Q000166:cytology; D012756:Sheep; D013908:Thoracotomy
D005466:Fluorocarbons