PARTIAL LIQUID VENTILATION IN CRITICALLY ILL INFANTS RECEIVING EXTRACORPOREAL LIFE-SUPPORT

Objectives. To demonstrate that a period of partial liquid ventilation (PLV) with perflubron improves pulmonary function, without adverse ev ents, in a select group of critically ill infants receiving extracorpo real life support (ECLS) with a high likelihood of mortality. Methods. This was an open-label, noncontrolled, phase I and II trial of PLV in two infants with congenital diaphragmatic hernia and four infants wit h acute respiratory distress syndrome (ARDS) who were failing to impro ve while receiving ECLS, PLV was performed by instilling and maintaini ng a functional residual capacity of sterile perflubron for 4 to 96 ho urs. Results. Four infants were successfully weaned off ECLS for at le ast 3 days, and two infants (both with ARDS) are long-term survivors a fter PLV. All infants demonstrated lung recruitment and improved lung compliance, and there were no adverse events related to PLV. Conclusio ns. The study suggests that perflubron PLV is safe, improves lung func tion, and recruits lung volume in critically ill infants receiving ECL S, PLV therapy for infants with ARDS seems to have a great deal of pro mise, Based on this and other phase I and II trials, studies of PLV on selected full-term infants before ECLS have been initiated.