Clinical correlation with changing radiographic appearance during partial liquid ventilation.
OBJECTIVE
To evaluate the chest radiographic filling pattern associated with partial liquid ventilation (PLV) with the perfluorochemical perflubron (LiquiVent; Alliance Pharmaceutical Corp; San Diego CA) as a function of dose and timing.


METHODS
Post hoc review of chest radiographs by three independent observers with correlation to clinical variables.


METHODS
Phase II randomized, uncontrolled, prospective, multicenter clinical trial.


METHODS
Sixteen adult patients with diffuse bilateral infiltrates consistent with acute lung injury and a PaO(2)/fraction of inspired oxygen (FIO(2)) ratio < 300 with positive end-expiratory pressure of 13 cm H(2)O and FIO(2) > or = 0.5.


METHODS
All patients were treated with either a 10-mL/kg or 20-mL/kg loading dose of perflubron followed by maintenance dosing at 3-h intervals to protocol-determined levels.


RESULTS
There was a significant relationship between inhomogeneous radiographic filling during the first 48 h of treatment and the use of the lower loading dose of perflubron. Inhomogeneous radiographic filling (in 5 patients) was associated with a lower high-dose/FIO(2) ratio at 24 h compared with the remaining patients. These differences resolved by 48 h. There were no other statistically significant correlations identified.


CONCLUSIONS
The radiographic appearance of PLV with perflubron appears to depend on the dose administered. Lower doses can be associated with both inhomogeneous radiographic filling and a transient deterioration in oxygenation during the first 24 to 48 h of treatment.
Schuster
D P
DP
Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO, USA. schusted@msnotes.wustl.edu
Lange
N R
NR
Tutuncu
A
A
Wedel
M
M
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D021061:Liquid Ventilation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging* / Q000628:therapy*