PERFLUOROCHEMICAL LIQUID VENTILATION - FROM THE ANIMAL LABORATORY TO THE INTENSIVE-CARE UNIT

Perfluorochemical or perfluorocarbon liquids have an enormous gas-carr ying capacity. During tidal liquid ventilation the respiratory medium of both functional residual capacity and tidal volume is replaced by n eat perfluorocarbon liquid. Tidal liquid ventilation is characterized by convective and diffusive limitations, but offers the advantage of p reserved functional residual capacity, high compliance and improved ve ntilation-perfusion matching. During partial liquid ventilation only t he functional residual capacity is replaced by perfluorocarbon liquid. Both tidal and partial liquid Ventilation improve gas exchange and lu ng mechanics in hyaline membrane disease, adult respiratory distress m odels and meconium aspiration. Compared to gas ventilation, there is l ess histologic evidence of barotrauma after liquid ventilation. Cardio -pulmonary interaction, inherent to the high density of liquid, and lo ng term safety need further study. However, extrapolating from animal data, and taking into account promising human pilot studies, liquid ve ntilation has the desired properties to occupy an important place in t he therapy of restrictive lung disease in man.