Optimizing Intrapulmonary Perfluorocarbon: Dosing Method and Mode of Ventilation 182

Partial liquid ventilation (PLV) appears promising in the treatment of severe acute lung injury, but the stategy for optimal intrapulmonary perflubron (PFC) distribution is unclear (perfluro-octyl bromide, LiquiVent®, Alliance Pharmaceutical Corp, San Diego, CA). We examined the effect of supine vs. rotational dosing on PFC distribution using conventional mechanical ventilation (CMV) or high frequency oscillatory ventilation (HFOV). METHODS: 13 piglets (wt 4.5-6.6 kg) underwent repetitive saline lavage to a target SpO2<90%,FiO2 1.0, PEEP 2, then either continued on CMV or conversion to HFOV. PFC was instilled in three 5cc/kg doses either with the pig supine (S) or alternating supine to prone (R) between each dose. Lateral cinefluoroscopic images at 90 min. were digitized. Image density increased with increasing PFC. A density index (DI) was calculated (mean image density/pixels²) of a 2 cm² window in three pre-vertebral (PV) and three substernal (SS) lung regions. Comparisons made with two-way factorial ANOVA and a Bonferroni/Dunn post-hoc subanalysis. RESULTS: See graph. CONCLUSIONS: PFC is more uniformly dispersed when dosed in a rotating fashion independent of mode of ventilation.

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