FULL-TIDAL LIQUID VENTILATION WITH PERFLUOROCARBON FOR PREVENTION OF LUNG INJURY IN NEWBORN NONHUMAN-PRIMATES

Hyaline membrane disease (HMD), the most common life-threatening respi ratory disorder of newborns, is associated with lung injury manifested by alveolar proteinaceous edema. The cause of the disease is thought to be elevated alveolar surface tension due to surfactant deficiency a t birth. Treatment with exogenous surfactant may be unsuccessful due t o problems in distribution of the surfactant, or inhibition of the sur factant by alveolar proteinaceous edema. Liquid ventilation with oxyge n-saturated perfluorocarbon liquid has been proposed as a method to el iminate alveolar surface tension; little is known about the interfacia l tension between perfluorocarbon liquids and the lung lining layer. P remature and term newborn monkeys were treated from birth with a press ure-limited, time-cycled liquid ventilator using oxygenated perfluoroc arbon liquids (APF-145 and perflubron). Adequate gas exchange was achi eved, and pilot experiments suggest long-term survival without adverse sequelae. Although many questions remain, liquid ventilation is a pro mising tool for the prevention and treatment of lung injury in newborn s.