title: The efficacy of partial liquid ventilation in lung protection during hypotension and cardiac arrest: preliminary study of lung transplantation using non-heart-beating donors.
abstract: BACKGROUND
  Because of the shortage of suitable brain-dead donors, the use of non-heart-beating donor lungs has been investigated experimentally. However, no effective lung protection method has been developed. In this study, we preliminarily investigated the protective effect of partial liquid ventilation (PLV) on a non-heart-beating rabbit lung.
  
  
  METHODS
  We used 20 male rabbits (mean weight, 3.7 kg) and divided them into 3 groups: the conventional ventilation (control) group, the PLV without cooling group, and the PLV with cooling group. After initially measuring donor cardiopulmonary function, we maintained hypotension at <50 mm Hg for 1 hour followed by 2-hour cardiac arrest. During this time, we used either conventional ventilation or PLV with or without cooling (4 degrees C) for ventilation, and we evaluated the changes in arterial blood gas analysis, pulmonary resistance and elastance, tissue interleukin-8 (IL-8) concentration, and histologic damage.
  
  
  RESULTS
  We found no significant difference in arterial oxygen concentration or in carbon dioxide tension among the 3 groups in the hypotensive phase. Pulmonary elastance increased after perfusion of preservation solution in the control group. However, we found no change in elastance in the PLV groups, which was less than that in the control group. Histologic evaluation after perfusion of preservation solution revealed that alveolar structure was damaged significantly less and cell infiltration was milder in the PLV groups than in the control group. Although IL-8 concentrations in the controls increased after cardiac arrest, IL-8 in the PLV groups remained at baseline concentrations during the study period.
  
  
  CONCLUSIONS
  In this experimental model of hypotension and cardiac arrest, PLV suppresses lung injury when compared with gas-controlled ventilation.
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yoshida
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sekine
authors.forename: Norihiro
authors.initials: N
authors.lastname: Shinozuka
authors.forename: Jiro
authors.initials: J
authors.lastname: Satoh
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yasufuku
authors.forename: Takekazu
authors.initials: T
authors.lastname: Iwata
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saitoh
authors.forename: Takehiko
authors.initials: T
authors.lastname: Fujisawa
mesh_terms: D000403:Airway Resistance; D000818:Animals; D001784:Blood Gas Analysis; D016207:Cytokines / Q000097:blood; D004195:Disease Models, Animal; D006323:Heart Arrest / Q000097:blood / Q000473:pathology / Q000503:physiopathology*; D007022:Hypotension / Q000097:blood / Q000473:pathology / Q000503:physiopathology*; D016209:Interleukin-8 / Q000378:metabolism; D021061:Liquid Ventilation; D008168:Lung / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D016040:Lung Transplantation; D008297:Male; D011817:Rabbits
chemical_list: D016207:Cytokines; D016209:Interleukin-8