PULMONARY PATHOLOGY OF PATIENTS TREATED WITH PARTIAL LIQUID VENTILATION

Initial trials of partial liquid ventilation (PLV), which is gas venti lation of perfluorocarbon-filled lungs, are underway in patients with severe respiratory failure, We report the first study of the effects o f the perfluorocarbon, perflubron, on the lung, Necropsies were conduc ted in nine patients (seven adults and two neonates; mean adult age, 3 1 +/- 5 yr) managed with PLV (average number of doses, 4 +/- 1), All o f the patients required extracorporeal life support. The patients had pneumonia with the acute respiratory distress syndrome (six patients), trauma/capillary leak syndrome (one patient), congenital diaphragmati c hernia (one patient), and primary pulmonary hypertension (one patien t), Nine adult patients (mean age, 37 +/- 5 yr) with acute respiratory distress syndrome requiring extracorporeal life support served as a c ontrol Pathologic findings were evaluated in both groups, Lung weights in the adult patients of both groups were elevated (mean weight of PL V-treated right lung, 1401 +/- 186 g; mean weight of PLV-treated left lung, 1131 +/- 177 g; mean weight of control right lung, 1018 +/- 91 g ; mean weight of control left lung, 988 +/- 80 g), There was no signif icant difference between the two groups (right lung, P = .066; left lu ng, P = .436), Frequent gross findings included focal consolidation, p atchy hemorrhage, and glassy cut surfaces, The histologic findings wer e similar in both groups, Diffuse alveolar damage (either proliferativ e phase or mixed proliferative and exudative phases) was seen in all n ine of the study patients, Eight of the nine control patients had diff use alveolar damage (five had proliferative phase only, one had mixed proliferative and exudative phases, and two had exudative phase only), One other patient had extensive parenchymal necrosis, Other frequent findings were intra-alveolar hemorrhage, numerous intra-alveolar macro phages, and organization of exudate, PLV with perflubron in patients w ith adult and neonatal respiratory distress syndromes is not associate d with unique pathologic findings in the human lung.