Small-dose perfluorocarbon reduces the recruitment pressure needed to open surfactant-deficient atelectatic lungs.
BACKGROUND
This study was undertaken to investigate the effect of a small dose of perfluorocarbon on the recruitment pressure needed to open atelectatic lung areas.


METHODS
In 12 Yorkshire pigs (body weight, 9 kg), lung injury was induced by whole lung lavage. After 1 h of conventional ventilation, an open lung maneuver was performed to obtain PaO2 values equal to the pre-lavage PaO2 values (+/-10%). After 1 h of ventilation at the lowest possible airway pressure that stabilized the recruited lung volume, the animals were disconnected from the ventilator to allow the lung to collapse. Six animals received a 5 ml/kg intratracheal dose of perfluorocarbon and a second open lung maneuver was performed. Six animals served as controls and received no perfluorocarbon but also underwent a second open lung maneuver.


RESULTS
In both groups, an open lung maneuver resulted in a significant increase in oxygenation. The peak pressures needed to open the lung after 1 h of mechanical ventilation in the perfluorocarbon and control groups were 43.8 +/- 8.4 cmH2O and 46.6 +/- 4 cmH2O, respectively. The addition of perfluorocarbon significantly reduced the opening pressure to 34.5 +/- 6.3 cmH2O (P < 0.01), whereas the opening pressure in the control group, 45.0 +/- 0.2 cmH2O, did not change.


CONCLUSIONS
The instillation of a small amount of perfluorocarbon significantly reduces the opening pressures needed to recruit atelectatic lung areas.
Houmes
R-J
RJ
Department of Anesthesiology, Erasmus MC-Faculty, Rotterdam, the Netherlands.
Lachmann
R A
RA
Haitsma
J J
JJ
Lachmann
B
B
D000399:Air Pressure; D000818:Animals; D002245:Carbon Dioxide / Q000097:blood; D005466:Fluorocarbons / Q000627:therapeutic use*; D006439:Hemodynamics / Q000502:physiology; D006863:Hydrogen-Ion Concentration; D008297:Male; D010100:Oxygen / Q000097:blood; D001261:Pulmonary Atelectasis / Q000503:physiopathology / Q000628:therapy*; D011659:Pulmonary Gas Exchange / Q000502:physiology; D011663:Pulmonary Surfactants; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D013552:Swine
D005466:Fluorocarbons; D011663:Pulmonary Surfactants; D002245:Carbon Dioxide; D010100:Oxygen