Aerosolized perfluorocarbon improves gas exchange and pulmonary mechanics in preterm lambs with severe respiratory distress syndrome.
BACKGROUND
Aerosolized perfluorocarbon (PFC) has been proposed as an alternative method of PFC administration; however, the efficacy of aerosolized PFC in a preterm animal model has not yet been demonstrated.


METHODS
Twelve preterm lambs were randomized to two groups: a perfluorodecalin (PFD) aerosol group (n = 6) receiving 10 ml/kg/h of PFD delivered by an intratracheal inhalation catheter followed by 4 h of mechanical ventilation (MV) or the control group, in which animals (n = 6) were managed for 6 h with MV. Gas exchange, pulmonary mechanics, cardiovascular parameters, and cerebral blood flow (CBF) were measured.


RESULTS
Both groups developed hypoxia, hypercarbia, and acidosis at baseline. Aerosolized PFD improved oxygenation (P < 0.0001) and pulmonary mechanics (P < 0.0001) and changed carbon dioxide values to normal physiological levels, unlike the treatment given to the controls (P < 0.0003). The time course of mean arterial blood pressure and CBF were significantly affected by PFD aerosolization, especially during the first hour of life. CBF gradually decreased during the first hour in the PFD aerosol group and remained stable until the end of the follow-up, whereas CBF remained higher in the control group (P < 0.0028).


CONCLUSIONS
Aerosolized PFD improves pulmonary function in preterm lambs and should be further investigated as an alternative mode of PFC administration.
Research Unit for Experimental Neonatal Respiratory Physiology, Cruces University Hospital, Bizkaia, Spain. xabier.murgiaesteve@osakidetza.net
Xabier
X
Murgia
Victoria
V
Mielgo
Adolf
A
Valls-i-Soler
Estibaliz
E
Ruiz-del-Yerro
Carmen
C
Rey-Santano
D000280:Administration, Inhalation; D000336:Aerosols; D000818:Animals; D062186:Arterial Pressure / Q000187:drug effects; D002560:Cerebrovascular Circulation / Q000187:drug effects; D005466:Fluorocarbons / Q000008:administration & dosage*; D005865:Gestational Age; D006339:Heart Rate / Q000187:drug effects; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D011659:Pulmonary Gas Exchange / Q000187:drug effects*; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D015656:Respiratory Mechanics / Q000187:drug effects*; D019141:Respiratory System Agents / Q000008:administration & dosage*; D012756:Sheep; D013997:Time Factors
D000336:Aerosols; D005466:Fluorocarbons; D019141:Respiratory System Agents; C008805:perfluorodecalin