Effects of vaporized perfluorohexane and partial liquid ventilation on regional distribution of alveolar damage in experimental lung injury

• Published in: Intensive care medicine 2007-02, Vol.33 (2), p.308-314
• Main Authors: SPIETH, Peter M, KNELS, Lilla, KASPER, Michael, DOMINGUES QUELHAS, André, WIEDEMANN, Bärbel, LUPP, Amelie, HÜBLER, Matthias, GIANELLA NETO, Antonio, KOCH, Thea, GAMA DE ABREU, Marcelo
• Format: Article
• Language: English
• Subjects: Acids; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Atmospheric pressure; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Digitization; Emergency and intensive respiratory care; Fluorocarbons - therapeutic use; Intensive care; Intensive care medicine; Liquid Ventilation - methods; Lungs; Medical sciences; Pharmacology. Drug treatments; Positive-Pressure Respiration; Pulmonary Alveoli - drug effects; Pulmonary Alveoli - pathology; Regions; Respiratory Distress Syndrome, Adult - drug therapy; Respiratory Distress Syndrome, Adult - pathology; Respiratory Distress Syndrome, Adult - therapy; Swine; Ventilators; Volatilization
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-006-0428-7

To determine whether the patterns of distribution of histological effects of vaporized perfluorohexane (PFH) and partial liquid ventilation (PLV) differ significantly in acute lung injury. Experimental study in an animal research laboratory. Eighteen pigs. After induction of acute lung injury by means of infusion of oleic acid animals were randomly assigned to PFH, PLV, or gas ventilation (GV) groups. Six hours thereafter animals were killed, and lung tissue samples were taken for analysis. Histopathological analysis revealed less damage with PFH than with GV or PLV in the nondependent and central regions. PFH and PLV showed less injury in the dependent regions than GV. GV and PFH were associated with less histological damage in the nondependent than the dependent regions, whereas PLV presented the opposite pattern. Morphometric analysis showed increased aeration in nondependent than dependent regions with PFH and GV. PLV led to more aeration in the periphery than in central areas. PFH was associated with a more homogeneous attenuation of alveolar damage across the lungs, although this therapy had more pronounced effects in nondependent zones. PLV showed the opposite pattern, with more important reduction in alveolar damage in dependent lung regions. Interestingly, reduction in alveolar damage with PFH was as effective as with PLV in dependent zones. Our findings suggest that vaporized perfluorocarbon could be advantageous as adjunctive therapy in the treatment of acute lung injury.