Liquid-assisted ventilation: An alternative respiratory modality

Wolfson, Marla R.; Greenspan, Jay S.; Shaffer, Thomas H.

doi:10.1002/(sici)1099-0496(199807)26:1<42::aid-ppul8>3.0.co;2-k

Cited by 79 publications

(68 citation statements)

References 136 publications

(230 reference statements)

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“…A sua captação é diretamente proporcional à vascularização do órgão ou tecido. Por exemplo, músculos e órgãos bem vascularizados, tais como o cérebro, ovário, rins e fígado, captam rapidamente o PFC, mas não o armazenam, enquanto o tecido adiposo e os lipídios encontrados no sangue o retêm em grande quantidade (17,20,21) . A sua velocidade de eliminação é de 20 minutos para os órgãos bem vascularizados, uma hora para o tecido muscular e quatro dias ou mais para o tecido adiposo depois da ventilação líqui-da.…”

Section: Metabolismo Dos Perfluorocarbonosunclassified

Ventilação líquida: revisão da literatura

2002

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Atualmente, novas alternativas de ventilação têm sido estudadas em quadros de insuficiência respiratória, com o objetivo de melhorar a oxigenação e minimizar a agressão ao parênquima pulmonar. A utilização de perfluorocarbonos líquidos administrados diretamente na via aérea vem sendo ostensivamente estudada em modelos de lesão pulmonar e em alguns ensaios clínicos, demonstrando bons resultados com relação à troca gasosa, mecânica ventilatória e propriedades antiinflamatórias. Os PFCs são substâncias que possuem baixa tensão superficial, alta densidade, são insolúveis em água, além de permitirem alta difusão de oxigênio e gás carbônico. Esses compostos atuam recrutando alvéolos colapsados, melhorando a oxigenação, protegendo a arquitetura pulmonar e atuando como carreadores de impurezas, limpando a superfície alveolar de resíduos da degradação celular. Neste artigo de revisão são apresentadas as diferentes modalidades ventilatórias com perfluorocarbonos e fornecidas informações sobre a utilização e o estado atual da ventilação líquida. (J Pneumol 2002;28(6):351-61)

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Section: Metabolismo Dos Perfluorocarbonosunclassified

Ventilação líquida: revisão da literatura

2002

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“…PFC liquids can be distributed homogeneously throughout the lungs at low pressures because of low surface tension properties. Furthermore, PFC liquids are biologically inert and appear to have no deleterious histologic, cellular, or biochemical effects (18). There are several commercially available PFC fluids with physicochemical properties and purity specifications appropriate for respiratory applications (19,20).…”

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Perfluorochemical Liquids Enhance Delivery of Superoxide Dismutase to the Lungs of Juvenile Rabbits

et al. 2006

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Previous studies suggest acute lung injury (ALI) in premature newborns is associated with relative deficiency of antioxidant enzymes that may be ameliorated by recombinant human superoxide dismutase (rhSOD). Perfluorochemicals (PFCs) are distributed homogeneously and support gas exchange in diseased lungs. We investigated whether PFCs could provide an effective delivery system for rhSOD. Juvenile rabbits were lung-lavaged, treated with surfactant, and randomized: group I: fluorescently labeled rhSOD (5 mg/kg in 2 mL/kg saline); group II: fluorescently labeled rhSOD (5 mg/kg in 18 mL/kg PFC). Animals were ventilated with oxygen for 4 h; the lungs were harvested for analysis of SOD distribution and oxidative injury. Cardiopulmonary indices remained stable and similar between groups. Qualitative assessment (QA) showed a more homogeneous lung SOD distribution in group II and a better histologic profile. QA of lung SOD distribution showed significant increase in SOD concentrations in group II (7.37 Ϯ 1.54 g/mg protein) compared with group I (1.65 Ϯ 0.23 g/mg protein). Oxidative injury as assessed by normalized protein carbonyl was 149.1 Ϯ 26.8% SEM in group II compared with 200.5 Ϯ 7.3% SEM in group I. Plasma SOD was significantly higher in group II. Administration of rhSOD with or without PFCs does not compromise cardiovascular function or impede lung recovery after ALI. PFCs enhance rhSOD delivery to the lungs by 400% while decreasing lung oxidative damage by 25% compared with rhSOD alone. These data suggest that PFCs optimize lung rhSOD delivery and might enhance the beneficial effects of rhSOD in preventing acute and chronic lung injury. (Pediatr Res 60: 65-70, 2006)

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“…The use of PFC as a medical material has been investigated during the past decades (1,2). Liquid-assisted ventilation, filling the lungs with PFC liquids during mechanical ventilation, including TLV and PLV, has proven effective in treating acute respiratory failure of premature, neonatal, and adult lungs (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11).…”

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confidence: 99%

“…Liquid-assisted ventilation, filling the lungs with PFC liquids during mechanical ventilation, including TLV and PLV, has proven effective in treating acute respiratory failure of premature, neonatal, and adult lungs (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). The properties of different PFC liquids influence physiologic and cellular responses during PLV and affect the dosing strategy (1, 2); however, there are a limited number of PFC fluids appropriate for respiratory applications.…”

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Perfluorochemical (PFC) Combinations for Acute Lung Injury: An In Vitro and In Vivo Study in Juvenile Rabbits

Jeng

2003

Pediatric Research

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Perfluorochemical (PFC) fluids of different physical properties were titrated and tested in vitro for physical properties that are appropriate for respiratory application. Two PFC liquids were studied: perfluoromethylcyclohexane (PP2), a liquid with high vapor pressure and low viscosity, and perfluoromethyldecalin (PP9), a fluid with low vapor pressure and high viscosity. Eighteen rabbits (2.05 Ϯ 0.07 kg; mean Ϯ SEM) were lunglavaged and randomized: group I, control group; group II, partial liquid ventilation with 75% PP2 and 25% PP9; group III, partial liquid ventilation with 50% PP2 and 50% PP9; and group IV, partial liquid ventilation with 25% PP2 and 75% PP9. Ventilator volumes were kept constant during the 4-h experiment. Cardiopulmonary measurements were performed every 30 min. The lung histology was examined. The in vitro study showed PFC [viscosity/vapor pressure (in cS and mm Hg, respectively)] as follows: 100% PP2 (0.88/141); 100% PP9 (3.32/2.9); 75% PP2 and 25% PP9 (1.26/107); 50% PP2 and 50% PP9 (1.63/13.7); and 25% PP2 and 75% PP9 (2.21/4.4). The in vivo experiments found that combinations of moderate vapor pressure (groups 3 and 4) demonstrated good gas exchange, compliance, and histo- The use of PFC as a medical material has been investigated during the past decades (1, 2). Liquid-assisted ventilation, filling the lungs with PFC liquids during mechanical ventilation, including TLV and PLV, has proven effective in treating acute respiratory failure of premature, neonatal, and adult lungs (1-11). The properties of different PFC liquids influence physiologic and cellular responses during PLV and affect the dosing strategy (1, 2); however, there are a limited number of PFC fluids appropriate for respiratory applications. Although several PFC liquids have been reported for liquid-assisted ventilation, including TLV and PLV (10, 12-18), there have been no studies exploring the effects of combining different PFC liquids to produce a fluid with optimum physical properties for respiratory therapy.All PFC liquids are immiscible to water, but they are soluble in each other (1). A PFC liquid suitable for respiratory application has the properties of high gas solubility and moderate vapor pressure and viscosity (2). Inasmuch as only a few PFC liquids are good candidates as a respiratory medium, a mixture

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Liquid-assisted ventilation: An alternative respiratory modality

Cited by 79 publications

References 136 publications

Ventilação líquida: revisão da literatura

Ventilação líquida: revisão da literatura

Perfluorochemical Liquids Enhance Delivery of Superoxide Dismutase to the Lungs of Juvenile Rabbits

Perfluorochemical (PFC) Combinations for Acute Lung Injury: An In Vitro and In Vivo Study in Juvenile Rabbits

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