Effects of inhalation of perfluorocarbon aerosol on oxygenation and pulmonary function compared to PGI(2) inhalation in a sheep model of oleic acid-induced lung injury

Objective: To evaluate the effects of PFC aerosol compared to PGI(2) aeroso l and NaCl aerosol on gas exchange and lung mechanics in oleic acid-induced acute lung injury. Design: A prospective, controlled, randomised, in vivo animal laboratory st udy. Setting: Research laboratory at an university hospital. Subjects: Twenty one (n = 21) adult sheep of either gender weighing 26.8 +/ - 6.4 kg. Interventions: The animals were randomised to three groups: PFC aerosol (pe rfluorooctane), PFC group; prostacyclin aerosol (Flolan), PGI(2) group; and NaCl aerosol (0.9 % sodium chloride solution), control group. After induct ion of anaesthesia and placement of vascular catheters, lung injury was ind uced with 0.12 ml(.)kg(-1) oleic acid. Aerosols were continuously administe red for 2 h using a jet nebuliser. Gas exchange, pulmonary mechanic, and ha emodynamic parameters were obtained at regular intervals. Measurements and main results. PFC aerosol increased oxygenation (PaO2) 15 min after the initiation of treatment up to 120 min (P < 0.05). Transpulmon ary shunt improved in the PFC group (P < 0.05) while it did not change in t he two other groups. PFC aerosol reduced maxi mum airway pressure (P-max) ( median) significantly from (median) 38 mbar to 32 mbar (P < 0.05). Static c ompliance improved significantly in the PFC group (P < 0.05). Conclusion: The inhalation of a PFC aerosol led to a significant improvemen t in pulmonary mechanics and gas exchange, which was not observed in the ot her two groups. These data suggest that a small dose of perfluorocarbon wil l have beneficial effects on gas exchange and respiratory mechanics. Theref ore, the non-invasive aerosol application technique seems to be a reasonabl e alternative to administer perfluorocarbons in severe lung injury.