title: Multicenter comparative study of conventional mechanical gas ventilation to tidal liquid ventilation in oleic acid injured sheep.
abstract: We performed a multicenter study to test the hypothesis that tidal liquid ventilation (TLV) would improve cardiopulmonary, lung histomorphological, and inflammatory profiles compared with conventional mechanical gas ventilation (CMV). Sheep were studied using the same volume-controlled, pressure-limited ventilator systems, protocols, and treatment strategies in three independent laboratories. Following baseline measurements, oleic acid lung injury was induced and animals were randomized to 4 hours of CMV or TLV targeted to "best PaO2" and PaCO2 35 to 60 mm Hg. The following were significantly higher (p < 0.01) during TLV than CMV: PaO2, venous oxygen saturation, respiratory compliance, cardiac output, stroke volume, oxygen delivery, ventilatory efficiency index; alveolar area, lung % gas exchange space, and expansion index. The following were lower (p < 0.01) during TLV compared with CMV: inspiratory and expiratory pause pressures, mean airway pressure, minute ventilation, physiologic shunt, plasma lactate, lung interleukin-6, interleukin-8, myeloperoxidase, and composite total injury score. No significant laboratories by treatment group interactions were found. In summary, TLV resulted in improved cardiopulmonary physiology at lower ventilatory requirements with more favorable histological and inflammatory profiles than CMV. As such, TLV offers a feasible ventilatory alternative as a lung protective strategy in this model of acute lung injury.
authors.affiliation: Department of Physiology, Temple University School of Medicine, Philadelphia, PA 19140, USA.
authors.forename: Marla R
authors.initials: MR
authors.lastname: Wolfson
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Hirschl
authors.forename: J Craig
authors.initials: JC
authors.lastname: Jackson
authors.forename: France
authors.initials: F
authors.lastname: Gauvin
authors.forename: David S
authors.initials: DS
authors.lastname: Foley
authors.forename: Wayne J E
authors.initials: WJ
authors.lastname: Lamm
authors.forename: John
authors.initials: J
authors.lastname: Gaughan
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Shaffer
mesh_terms: D000818:Animals; D006439:Hemodynamics; D007249:Inflammation / Q000473:pathology; D021061:Liquid Ventilation; D008168:Lung / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D055370:Lung Injury; D019301:Oleic Acid / Q000633:toxicity; D012121:Respiration, Artificial / Q000009:adverse effects; D015656:Respiratory Mechanics; D012756:Sheep
chemical_list: D019301:Oleic Acid