Bronchoscopic lavage with perfluorocarbon decreases postprocedure hypoxemia in an ovine model of smoke inhalation

Objective: Bronchoscopy and lavage are used to confirm diagnosis and can be therapeutic in patients suffering inhalation injury. Lavage is traditional ly performed using saline, which is unfortunately associated with profound transient hypoxemia, Perfluorocarbons, having a high gas solubility for oxy gen and carbon dioxide, increase oxygenation when instilled into the airway . We hypothesized that the use of perfluorocarbons for bronchoscopic lavage would attenuate this transient hypoxemia. Methods: Sheep were prepared for chronic study, They were insufflated with cotton smoke and then randomized to receive a lavage with 200 mL of perfluo rocarbon or saline at 2, 6, 12, and 24 hours after injury. Results: All animals had a steady and significant decline in their pre- to post-PaO2FIO2 (P/F) ratio, At 2, 6, and 12 hours, the saline lavage group h ad a significant decrease in their P/F ratio (485 +/- 32 to 212 +/- 37 mm H g, 439 +/- 22 to 170 +/- 40 mm Hg, and 381 +/- 48 to 184 +/- 59 mm Hg), Thi s decrease in P/F ratio was not observed in the perfluorocarbon group (474 +/- 19 to 459 +/- 29 mm Hg, 424 +/- 32 to 387 +/- 43 mm Hg, and 366 +/- 50 to 357 +/- 67 mm Hg). Conclusion: These findings indicate that perfluorocarbons attenuate the tra nsient hypoxemia associated with saline bronchoscopic lavage and thus may b e considered safer for patients with acute lung injury.