title: Partial liquid ventilation with surfactant: effects on gas exchange and lung pathology in surfactant-depleted piglets.
abstract: OBJECTIVE
  To evaluate the effects of 24 h partial liquid ventilation (PLV) with and without surfactant (S) treatment on gas exchange and lung injury in a newborn animal model of S deficiency.
  
  
  METHODS
  A prospective, controlled, in vivo animal laboratory study.
  
  
  METHODS
  Research laboratory in a university setting.
  
  
  METHODS
  Twenty-four pathogen-free, male piglets (mean weight 1.9 kg, age 1-3 days).
  
  
  METHODS
  The animals were randomised in four groups: PLV with FC-77 combined with conventional ventilation (PLV/CV) versus S + PLV/CV and PLV combined with high frequency oscillatory ventilation (PLV/HFOV) versus S + PLV/HFOV. The piglets were anaesthetised, intubated and instrumented with vascular catheters. Thirty minutes after lung injury had been induced with repeated saline lavage, S animals received natural S. Thirty minutes after surfactant substitution PLV with FC-77 was started. The oxygenation index (OI), PaO(2)/FIO(2) ratio, PaCO(2) and the ventilatory efficacy index were determined before and during PLV. After 24 h the lungs were removed for histopathological examination.
  
  
  RESULTS
  Within 60 min after the initiation of PLV, all animals demonstrated improvements of the OI and PaO(2)/FIO(2) ratio compared to the values after lung injury. However, at 18 and 24 h of PLV, the OI and PaO(2)/FIO(2) ratio were significantly worse in the S + PLV/CV and S + PLV/HFOV groups compared to the groups without S. PaCO(2) was higher at 18 and 24 h when S was used in PLV/HFOV (p < 0.05). A semi-quantitative lung injury score revealed most severe lung damage in the S + PLV/HFOV group. CONCLUSIONS++: The combination of S and PLV with FC-77 led to an impaired gas exchange and did not further protect the animal from lung injury.
authors.affiliation: Children's Hospital, Neonatal Intensive Care, Aachen University of Technology, Pauwelsstrasse 30, D-52074 Aachen, Germany. umerz@post.klinikum
authors.forename: U
authors.initials: U
authors.lastname: Merz
authors.forename: M
authors.initials: M
authors.lastname: Kellinghaus
authors.forename: M
authors.initials: M
authors.lastname: Häusler
authors.forename: N
authors.initials: N
authors.lastname: Pakrawan
authors.forename: B
authors.initials: B
authors.lastname: Klosterhalfen
authors.forename: H
authors.initials: H
authors.lastname: Hörnchen
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D005466:Fluorocarbons / Q000008:administration & dosage; D006439:Hemodynamics; D006612:High-Frequency Ventilation; D008297:Male; D011659:Pulmonary Gas Exchange; D011663:Pulmonary Surfactants / Q000008:administration & dosage* / Q000172:deficiency*; D012121:Respiration, Artificial / Q000379:methods*; D012131:Respiratory Insufficiency / Q000473:pathology* / Q000628:therapy; D013552:Swine
chemical_list: D005466:Fluorocarbons; D011663:Pulmonary Surfactants