Effects of partial liquid ventilation on cerebral blood flow and cerebral metabolism in neonatal lambs

Dimmitt, Y. Reed A.; Beckman, Sarah; Moss, Richard L.; Mickas, Nick A.; Falco, Daniel A.; Chubb, C. F.; Skarsgard, Erik D.

doi:10.1053/jpsu.2002.32884

Cited by 2 publications

(2 citation statements)

References 25 publications

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“…There have been other published reports of studies investigating the effect of partial liquid ventilation on cerebral blood flow [8,9,22,[24][25][26]. Two of the reports are our previous studies in preterm lambs [8,9].…”

Section: Interpretation Of the Resultsmentioning

confidence: 99%

The effects of perfluorocarbon dosing strategy on cerebral blood flow when starting partial liquid ventilation: A randomized, controlled, experimental study

Davies¹,

Dunster²,

Fraser³

et al. 2012

OJPed

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Introduction: Partial liquid ventilation may benefit the lung disease in preterm neonates but intratracheal instillation of perfluorocarbon increases cerebral blood flow and may cause brain injury. We aimed to determine if the effects of perfluorocarbon administration on cerebral blood flow vary by dose-volume, rate of administration, endotracheal tube portal of entry, or closely targeting PaCO2. Methods: Forty-two dosing events (in eleven rabbits) were randomised to different dosing strategies, including a sham (i.e., placebo/control) dose of air over 20 min, 20 mL/kg of perfluorocarbon slowly over 20 min, 10 mL/kg of perfluorocarbon slowly over 20 min, 10 mL/kg of perfluorocarbon moderately fast over 10 min, 10 mL/kg of perfluorocarbon rapidly over 5 min, 10 mL/kg of perfluorocarbon slowly over 20 min via the endotracheal tube tip lumen (as opposed to the proximal end of the tube used in all other groups), or 10 mL/kg of perfluorocarbon slowly over 20 min whilst targeting a PaCO2 of 45 - 50 mmHg. Blood gases, haemodynamics, cortical cerebral blood flow and carotid flow were recorded continuously for 30 minutes from the start of each dose. Results: Carotid flow increased with 20 mL/kg perfluorocarbon and cortical cerebral blood flow was significantly more variable. Carotid and cortical cerebral blood flow increased using 10 mL/kg or 20 mL/kg with no difference between the two dose-volumes. There was no difference in cerebral blood flow by rate of administration, but carotid blood flow was more variable during slow administration. There were no differences in the increase in cerebral blood flow by portal of entry. If PaCO2 was maintained between 45 - 50 mmHg there was no increase in cerebral blood flow and there was less variable carotid flow. Conclusions: Cerebral blood flow increases with perfluorocarbon dosing. This occurs regardless of the dose-volume of perfluorocarbon. These effects were mitigated by closely targeting PaCO2

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Section: Interpretation Of the Resultsmentioning

confidence: 99%

The effects of perfluorocarbon dosing strategy on cerebral blood flow when starting partial liquid ventilation: A randomized, controlled, experimental study

Davies¹,

Dunster²,

Fraser³

et al. 2012

OJPed

View full text Add to dashboard Cite

show abstract

“…Also term piglets may have behaved differently to preterm lambs. Dimmitt et al [25] found that carotid blood flow was the same during partial liquid ventilation as it was during conventional gas ventilation in term lambs (cerebral metabolic rates for oxygen, glucose and lactate were similar in the two groups). Once again the finding that carotid blood flow was unaffected may have been due to the fact that term animals were used, that the changes in cerebral blood flow may have normalised following the initial dosing of perfluorocarbon liquid or that there was no lung disease.…”

Section: Discussionmentioning

confidence: 95%

Perfluorocarbon Dosing when Starting Partial Liquid Ventilation: Haemodynamics and Cerebral Blood Flow in Preterm Lambs

Davies

Dunster²,

Wilson

et al. 2009

Neonatology

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Background: Very preterm neonates can have severe lung disease and are prone to brain injury if cerebral blood flow fluctuates. Partial liquid ventilation (PLV) may benefit the lung disease, but it is unknown whether the administration of intratracheal perfluorocarbon when starting PLV affects haemodynamics or cerebral blood flow. Objectives: To determine if haemodynamics or cerebral blood flow are affected in preterm lambs receiving a dose of perfluorocarbon when starting PLV. Methods: Sixteen preterm lambs were randomised to either PLV or conventional mechanical ventilation. An intratracheal loading dose of 30 ml/kg of perfluorocarbon liquid (PLV group) or air (sham group) was instilled over 20 min. Data were collected continuously for 30 min from the start of dosing. Results: Cortical cerebral blood flow velocity, measured continuously with laser Doppler, was increased in the PLV group during the administration of perfluorocarbon and immediately thereafter (p = 0.0026); the highest mean increase in the PLV group was 27%. There was no difference in cortical cerebral blood flow variability (p = 0.96). There was a slightly lower mean arterial blood pressure in the PLV group; the heart rate did not differ between groups. The PaCO₂ was higher in the PLV group at 30 min – the difference between groups was not statistically significant (difference between means = 5.5 mm Hg, 95% confidence interval –2.7 to 13.7). Conclusions: Preterm lambs receiving a dose of tracheal perfluorocarbon at the start of PLV have an increased cortical cerebral blood flow velocity, but no change in cortical cerebral blood flow variability.

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Effects of partial liquid ventilation on cerebral blood flow and cerebral metabolism in neonatal lambs

Cited by 2 publications

References 25 publications

The effects of perfluorocarbon dosing strategy on cerebral blood flow when starting partial liquid ventilation: A randomized, controlled, experimental study

The effects of perfluorocarbon dosing strategy on cerebral blood flow when starting partial liquid ventilation: A randomized, controlled, experimental study

Perfluorocarbon Dosing when Starting Partial Liquid Ventilation: Haemodynamics and Cerebral Blood Flow in Preterm Lambs

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