Combining partial liquid ventilation and prone position in experimental acute lung injury

Background: Partial Liquid ventilation (PLV) and prone position can improve arterial oxygen tension (Pa-O2) in acute lung injury (ALI). The authors ev aluated additive effects of these techniques in a saline lung lavage model of ALI. Methods: ALI was induced in 20 medium-sized pigs (29.2 +/- 2.5 kg body weig ht). Gas exchange and hemodynamic parameters were determined in both supine and prone position in all animals. Thereafter, one group was assigned to P LV with two sequential doses of 15 ml/kg of perfluorocarbon (n = 10); the s econd group was assigned to gaseous ventilation (n = 10). Gas-exchange and hemodynamic parameters were determined at corresponding time points in both groups in prone and supine position. Results: In the PLV group, positioning the animals prone resulted in an inc rease of Pa-O2 prior to PLV and during PLV with both doses of perfluorocarb on when compared to ALI. PLV in supine position was only effective if 30 ml /kg of perfluorocarbon was applied. In the gaseous ventilation group, Pa-O2 increased reproducibly compared with ALI when the animals were turned pron e. A significant additive improvement of arterial oxygenation was observed during combined therapy with 30 mVkg of perfluorocarbon and prone position in the PLV group compared with either therapy alone. Conclusions: The authors conclude that combining PLV with prone position ex erts additive effects on pulmonary gas exchange in a saline lung lavage mod el of ALI in medium-sized pigs.