Tracheal gas insufflation with partial liquid ventilation to treat LPS-induced acute lung injury in juvenile piglets.
OBJECTIVE
Partial liquid ventilation (PLV) with perfluorocarbons (PFC) seems not superior to conventional ventilation clinically. We hypothesized that a combination of continuous tracheal gas insufflation (TGI) with protective strategy of PLV (low dose of PFC, low inflation pressure, moderate inhalation of oxygen and moderate anesthesia) would improve cardiopulmonary function in acute lung injury.


METHODS
Twenty-four healthy juvenile piglets were anesthetized and mechanically ventilated at PEEP of 2 cmH(2)O with a peak inspiratory pressure of 10 cmH(2)O and FIO(2) of 0.4. The piglets were challenged with lipopolysaccharide and randomly assigned to four groups (n = 6 each): (1) mechanical ventilation alone (MV); (2) PLV with perfluorodecalin (10 ml/kg); (3) TGI with continuous airway flow 2 L/min; and (4) combination of PLV and TGI. The outcome was assessed functionally and histologically.


RESULTS
All treatments except MV improved pH, PaO(2)/FIO(2), PaCO(2), ventilation efficacy index (VEI) and tidal volume. Both PLV-associated treatments also improved heart rate, respiratory rate, pulse contour cardiac output, systemic vascular resistance, dynamic lung compliance, mean airway resistance and mean airway pressure. The combination group resulted in higher PaO(2)/FIO(2), VEI and a better lung histology score than any other treatments.


CONCLUSIONS
The new protective strategy may provide a better treatment for sepsis-induced acute lung injury.
Guo
Zhong-Liang
ZL
Department of Respiratory Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China. drguozhl@163.com
Liang
Yong-Jie
YJ
Lu
Guo-Ping
GP
Wang
Jun-Chen
JC
Ren
Tao
T
Zheng
Yong-Hua
YH
Gong
Jing-Yu
JY
Yu
Jerry
J
D055371:Acute Lung Injury / Q000276:immunology / Q000628:therapy*; D000403:Airway Resistance; D000818:Animals; D002302:Cardiac Output; D005260:Female; D005466:Fluorocarbons / Q000627:therapeutic use; D006339:Heart Rate; D007327:Insufflation; D008070:Lipopolysaccharides / Q000276:immunology; D021061:Liquid Ventilation / Q000379:methods*; D008168:Lung / Q000033:anatomy & histology / Q000503:physiopathology; D008170:Lung Compliance; D008297:Male; D012123:Pulmonary Ventilation; D012121:Respiration, Artificial / Q000379:methods; D056152:Respiratory Rate; D013552:Swine; D014132:Trachea; D014655:Vascular Resistance
D005466:Fluorocarbons; D008070:Lipopolysaccharides