Partial liquid ventilation with perfluorocarbons for treatment of ARDS in burns

Pulmonary failure remains the major determinant of mortality and morbidity following burn injury. We hypothesized that intratracheal instillation of p erfluorocarbon liquids could be a therapeutic measure in combination with c onventional mechanical ventilation to improve pulmonary gas exchange in acu te respiratory distress syndrome with thermal injury. Forty-five New Zealan d rabbits were used for this prospective and randomized experimental study. The animals were burned by scald to reach fall-thickness 40% burn surface area. After inducing respiratory distress by repeated lung lavage with sali ne, animals were divided randomly into three groups of 15 rabbits each. Fir st group (control group) received conventional treatment (continuous positi ve-pressure ventilation) using a FiO(2) of 1.0, tidal volume of 12 ml/kg, r espiratory frequency of 30 cycles/min and PEEP of 6 cm H2O. Second group wa s treated with 9 ml/kg of intratracheal perfluorocarbon. Third group was tr eated with 15 ml/kg of intratracheal perfluorocarbon. All groups were venti lated for 6 h. In the perfluorocarbon groups, PaO2 increased significantly (P < 0.05) from 46 +/- 4 to 439 +/- 10 mmHg compared to the control group i n a dose-related manner. In pulmonary parameters we observed significant (P < 0.05) decrease in mean airway pressures from the pre-treatment value of 11.44 +/- 0.15 cm. H2O to the post treatment 10.22 +/- 0.12 cm H2O and incr ease (P < 0.05) in respiratory system compliance from 1.8 +/- 0.02 to 2.46 +/- 0.07 ml/cm H2O with the perfluorocarbon. Perfluorocarbon instillation d id not result in statistically significant changes in arterial pressure, he art rate and central venous pressure. In conclusion, partial liquid ventila tion with perfluorocarbon is a new technique leading improvement in oxygena tion and pulmonary function in an experimental model of ARDS in burns. (C) 2001 Elsevier Science Ltd and ISBI. All rights reserved.