Partial liquid ventilation shows dose-dependent increase in oxygenation with PEEP and decreases lung injury associated with mechanical ventilation

Purpose: The purpose of this article is to evaluate the effect of positive end-expiratory pressure (PEEP) during partial liquid ventilation (PLV) and to investigate if lung damage associated with mechanical ventilation can be reduced by PLV, Materials and Methods: Twenty-two New-Zealand white rabbits were ventilated in pressure-controlled mode maintaining constant tidal volume (10 mL/kg). Lung injury was induced by repeated saline lavage (Pa-O2 < 100 mm Hg). Two incremental PEEP steps maneuvers (IPSMs) from 2 to 10 cm H2O in 2 cm H2O st eps were performed sequentially. The control group received the first IPSM in the supine position and were turned prone for the second IPSM. In the PL V group (n = 7), 12 mL/kg of perfluorodecalin was instilled after lung inju ry before the two IPSMs. The early prone group (n = 7) received both IPSMs in the prone position. Parameters of gas exchange, lung mechanics, and hemo dynamics as well as pathology were examined. Results: During the first IPSM, the PLV group showed a significant increase in Pa-O2 after instillation of perfluorodecalin (P < .05) and then showed a dose-dependent increase in Pa-O2 with PEER The control and EP groups show ed improvement in Pa-O2 only at higher PEEP, eventually showing no intergro up differences at PEEP of 10 cm H2O. During the second IPSM only the PLV gr oup retained its ability to increase Pa-O2 to the level obtained during the first IPSM (P < .05 compared with control and EP groups). During the first IPSM all three groups showed increasing trend in static compliance (Cst) w ith PEEP, peaking at PEEP of 8 cm H2O. During the second IPSM, only the PLV group showed increase in static compliance with PEEP (P < .05 compared wit h other groups). Lung histology revealed significantly less hyaline membran e formation in the PLV group (P < .05). Conclusion: PLV shows dose-dependent increase in oxygenation with PEEP and may reduce lung damage associated with mechanical ventilation. Copyright (C ) 2000 by W.B. Saunders Company.