PARTIAL LIQUID VENTILATION IN NEWBORN PATIENTS WITH CONGENITAL DIAPHRAGMATIC-HERNIA

The authors evaluated the safety and efficacy of liquid ventilation wi th perfluorocarbon in four newborns with congenital diaphragmatic hern ia and severe respiratory failure, who were on extracorporeal life sup port (ECLS). After 2 to 5 days on the ECLS, perflubron was administere d into the trachea until the dependent zone of the lung was filled. Th e first dose was 6 +/- 1 mL/kg (range, 5 to 8 mL/kg). Gas ventilation of the perflubron-filled lung was performed (partial liquid ventilatio n). The administration of perflubron was repeated daily for 5 to 6 day s, with total cumulative doses of 36 +/- 8 mL/kg (range, 26 to 44 mL/k g). A significant increase in PaO2 (P = .027 by repeated-measures anal ysis of variance [ANOVA]). a trend toward an increase in arterial oxyg en content (P = .052 by repeated-measures ANOVA), and a significant in crease in specific static total pulmonary compliance (P = .007 by repe ated-measures ANOVA) were observed after administration of the daily d ose of perflubron. PaCO2 data showed a decreasing trend (P = .08 by re peated-measures ANOVA). The authors conclude that perflubron can be sa fely administered into the lungs of newborn patients with congenital d iaphragmatic hernia and severe respiratory failure, and it may be asso ciated with improvement in gas exchange and pulmonary compliance. (C) 1996 by W.B. Saunders Company