NEONATES WITH CONGENITAL DIAPHRAGMATIC-HERNIA - RADIOGRAPHIC FINDINGSDURING PARTIAL LIQUID VENTILATION

PURPOSE: To determine the serial radiographic appearance of the lungs of neonates who underwent partial liquid ventilation with perflubron b ecause of congenital diaphragmatic hernia (CDH) or primary pulmonary h ypertension. MATERIALS AND METHODS: Bedside anteroposterior (AP) and l ateral chest radiographs (n = 235) were scored for percentage of lung opacification by perflubron during partial liquid ventilation (PLV) an d extracorporeal membrane oxygenation (ECMO). Five neonates participat ed in the study; four had CDH, and one had primary pulmonary hypertens ion. RESULTS: The lungs were opacified nearly completely after each do se of perflubron. The degree of opacification was the same on 117 of 1 69 (69%) AP radiographs and within one point on another 40 (24%). A gr avity-dependent distribution was shown on 58 of 66 (88%) lateral radio graphs. A minimal amount of perflubron remained in the lungs after 5.2 days. A hypoplastic bronchus and ipsilateral lung were manifest in al l four of the patients with CDH after the airway and lung were filled with radiopaque perflubron. CONCLUSION: Lungs filled with perflubron w ere opacified to a similar degree in a gravity-dependent distribution. Evaporation of perflubron from the lungs of neonates is relatively ra pid. The size of the ipsilateral bronchus and lung may be estimated by comparison of radiographs taken before and after the lungs were fille d with perflubron.