Little is known about perfluorocarbon (PFC) used with surfactant. Does“priming” the lung with PFC potentiate gas exchange? We compared physiologic parameters, pulmonary mechanics and gas exchange using conventional ventilation with PFC and surfactant. We studied 18 newborn piglets (1.5± 0.6 kg) with saline lavage-induced lung injury(PaO2<60 torr, FiO2 1.0). Animals were randomized to three groups of 6: surfactant only (S; Survanta®), intratracheal PFC priming(perfluorooctylbromide; LiquiVent®), and PFC followed by surfactant(PFC-S). S animals received surfactant after induction of injury. PFC and PFC-S animals had FRC amounts of PFC instilled intratracheally (30-50 ml/kg); ventilation continued for thirty minutes, then animals were suctioned. PFC-S animals then received surfactant. Ventilators were adjusted to maintain tidal volume of 12-15 cc/kg. Arterial blood gases, arterial and central venous pressures, heart rates, and dynamic and static lung mechanics were measured and A/a ratios and Ols calculated every 30 minutes for two hours following treatment. We analyzed% change from baseline after lung injury using 2 way ANOVA, then Newman-Keuls tests. Table *p<0.05. Physiologic parameters and dynamic pulmonary mechanics were not significantly different. A/a ratio, OI, pH and Cstat showed significant differences between treatment groups. PFC-S produced the best gas exchange and the largest% change from baseline in Cstat, suggesting synergy between PFC and surfactant. Conclusions: PFC priming and surfactant together provide improved gas exchange in saline lavage-induced lung injury compared with either PFC or surfactant alone. Improvements in Cstat suggest more uniform surfactant distribution following PFC priming. (LiquiVent® supplied by Alliance Pharmaceutical Corp; Survanta® supplied by Ross Laboratories)

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