LONG-TERM PARTIAL LIQUID VENTILATION (PLV) WITH PERFLUBRON IN THE NEAR-TERM BABOON NEONATE

Purpose: The feasibility and safety of continuous long-term (4-5 day) partial liquid ventilation (PLV) using peflubron was demonstrated in n ewborn baboons. PLV, a potential therapy for adult and neonatal respir atory distress syndrome (RDS), is conventional mechanical ventilation (CMV) with the lung filled to about functional residual capacity with perfluorochemical liquid. Protocol: As a pilot trial for a larger prec linical study focused on the safety of extended duration PLV, three ne ar term baboons were studied. The animals were delivered by cesarean s ection, anesthetized, intubated and placed on CMV. The animals were gi ven intratracheal perflubron (30 ml/kg) and maintained on PLV for 96 h ours. The transition back to gas ventilation occurred, after draining, over the fifth day (hrs 96-120). Results: Two of the animals were bor n with normal pulmonary function, while the third developed respirator y distress prior to PLV. All the animals were adequately supported wit h PLV using moderate ventilator settings and low concentrations of oxy gen. Perflubron distribution was enhanced by periodic rotation of the animals. Preliminary histology show vacuolated alveolar macrophages an d no evidence of edema or other significant changes in the lungs. Pulm onary function in the RDS animal, after PLV treatment, showed normal g as exchange and lung mechanics. Conclusions: Three near term baboons, one with clinical RDS, tolerated 4 days of PLV followed by 1 day of CM V without complications using practical clinical management methods.