title: Partial liquid ventilation shows dose-dependent increase in oxygenation with PEEP and decreases lung injury associated with mechanical ventilation.
abstract: OBJECTIVE
  The purpose of this article is to evaluate the effect of positive end-expiratory pressure (PEEP) during partial liquid ventilation (PLV) and to investigate if lung damage associated with mechanical ventilation can be reduced by PLV.
  
  
  METHODS
  Twenty-two New-Zealand white rabbits were ventilated in pressure-controlled mode maintaining constant tidal volume (10 mL/kg). Lung injury was induced by repeated saline lavage (PaO2 < 100 mm Hg). Two incremental PEEP steps maneuvers (IPSMs) from 2 to 10 cm H2O in 2 cm H2O steps were performed sequentially. The control group received the first IPSM in the supine position and were turned prone for the second IPSM. In the PLV group (n = 7), 12 mL/kg of perfluorodecalin was instilled after lung injury before the two IPSMs. The early prone group (n = 7) received both IPSMs in the prone position. Parameters of gas exchange, lung mechanics, and hemodynamics as well as pathology were examined.
  
  
  RESULTS
  During the first IPSM, the PLV group showed a significant increase in PaO2 after instillation of perfluorodecalin (P < .05) and then showed a dose-dependent increase in PaO2 with PEER. The control and EP groups showed improvement in PaO2 only at higher PEEP, eventually showing no intergroup differences at PEEP of 10 cm H2O. During the second IPSM only the PLV group retained its ability to increase PaO2 to the level obtained during the first IPSM (P < .05 compared with control and EP groups). During the first IPSM all three groups showed increasing trend in static compliance (Cst) with PEEP peaking at PEEP of 8 cm H2O. During the second IPSM, only the PLV group showed increase in static compliance with PEEP (P < .05 compared with other groups). Lung histology revealed significantly less hyaline membrane formation in the PLV group (P < .05).
  
  
  CONCLUSIONS
  PLV shows dose-dependent increase in oxygenation with PEEP and may reduce lung damage associated with mechanical ventilation.
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Samsung Biomedical Research Institute, Seoul. Korea.
authors.forename: G Y
authors.initials: GY
authors.lastname: Suh
authors.forename: M P
authors.initials: MP
authors.lastname: Chung
authors.forename: S J
authors.initials: SJ
authors.lastname: Park
authors.forename: Y
authors.initials: Y
authors.lastname: Koh
authors.forename: K W
authors.initials: KW
authors.lastname: Kang
authors.forename: H
authors.initials: H
authors.lastname: Kim
authors.forename: J
authors.initials: J
authors.lastname: Han
authors.forename: C H
authors.initials: CH
authors.lastname: Rhee
authors.forename: O J
authors.initials: OJ
authors.lastname: Kwon
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D006439:Hemodynamics; D021061:Liquid Ventilation; D008168:Lung / Q000473:pathology; D008297:Male; D010100:Oxygen / Q000378:metabolism; D010313:Partial Pressure; D011175:Positive-Pressure Respiration; D016684:Prone Position; D011817:Rabbits; D011897:Random Allocation; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D015656:Respiratory Mechanics; D016683:Supine Position
chemical_list: D010100:Oxygen