Distribution of pulmonary blood flow and total lung water during partial liquid ventilation in acute lung injury

Background. Gas exchange is improved during partial liquid ventilation (PLV) with perfluorocarbon in animal models of acute lung injury. The mechanisms are not fully defined. We hypothesize that redistribution of pulmonary blood flow (PBF) along with redistribution of and decrease in, total lung wat...

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Bibliographic Details
Published in:Surgery 1997-08, Vol.122 (2), p.313-323
Main Authors: Gauger, Paul G, Overbeck, Michael C, Koeppe, Robert A, Shulkin, Barry L, Hrycko, Julia N, Weber, Erik D, Hirschl, Ronald B
Format: Article
Language:English
Subjects:
Animals
Body Water - physiology
Dogs
Fluorocarbons
Lung - diagnostic imaging
Lung - physiology
Lung Injury
Oxygen Radioisotopes
Pulmonary Circulation - physiology
Pulmonary Ventilation
Regional Blood Flow
Time Factors
Tomography, Emission-Computed
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Summary:Background. Gas exchange is improved during partial liquid ventilation (PLV) with perfluorocarbon in animal models of acute lung injury. The mechanisms are not fully defined. We hypothesize that redistribution of pulmonary blood flow (PBF) along with redistribution of and decrease in, total lung water (TLW) during PLV may improve oxygenation. Methods. We characterized PBF and TLW in anesthetized adult dogs by using positron emission tomography with H 2 15 O . Measurements of gas exchange, PBF, and TLW were made before and after acute lung injury was induced with intravenous oleic add. The same measurements were made during PLV (with 30 ml/kg perfluorocarbon) and compared with gas ventilated (GV) controls. Results. Oxygenation was significantly improved during PLV. PBF redistributed from the dependent zone of the lung to the nondependent zones, thus potentially improving ventilation/perfusion relationships. However, a similar pattern of PBF redistribution was observed during GV such that there was no significant difference between groups. TLW redistributed in a similar pattern during PLV. By quantitative measurements, PLV ameliorated the continued accumulation of TLW compared with GV animals. Conclusions. We conclude that PBF and TLW redistribution and attenuation of increases in TLW may contribute to the improvement in gas exchange during PLV in the setting of acute lung injury.
ISSN:0039-6060
1532-7361
DOI:10.1016/S0039-6060(97)90023-4