Effects of partial liquid ventilation on cerebral blood flow and cerebral metabolism in neonatal lambs

• Published in: Journal of pediatric surgery Vol. 37; no. 6; pp. 840 - 844
• Main Authors: Dimmitt, Reed A., Beckman, Sarah A., Halamek, Louis P., Moss, R.Lawrence, Mickas, Nick A., Falco, Daniel A., Chubb, Christopher, Skarsgard, Erik D.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.06.2002; Elsevier
• Subjects: Airway Resistance; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Animals, Newborn; Biological and medical sciences; Blood Gas Analysis; Brain - metabolism; Carotid Arteries - physiology; carotid blood flow; Catheterization, Central Venous; cerebral metabolism; Cerebrovascular Circulation - physiology; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Humans; Intensive care medicine; intraventricular hemorrhage; Liquid Ventilation - adverse effects; mechanical ventilation; Medical sciences; Oxygen Consumption - physiology; partial liquid ventilation; Perfluorocarbon; perfluorodecalin; periventricular leukomalacia; Pneumology; Regional Blood Flow; Respiratory system : syndromes and miscellaneous diseases; Sheep; Tracheostomy; Vascular Resistance; carotid blood flow; periventricular leukomalacia; mechanical ventilation; intraventricular hemorrhage; Perfluorocarbon; perfluorodecalin; partial liquid ventilation; cerebral metabolism; Liquid ventilation; Respiratory disease; Experimental study; Metabolism; Lamb; Blood flow; Vertebrata; Mammalia; Treatment; Respiratory failure; Partial; Newborn animal; Sheep; Artiodactyla; Biological effect; Ungulata; Resuscitation; Brain (vertebrata)
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1053/jpsu.2002.32884

Background/Purpose: Liquid ventilation is a promising therapy for respiratory failure. The effects of perfluorochemical on cardiac output have not been well described. The purpose of this study was to compare cerebral blood flow (QCAROTID) and cerebral metabolic rates (CMR) during conventional ventilation (CV) and partial liquid ventilation (PLV). Methods: Five 2-week-old lambs underwent tracheostomy and central venous, aortic, and postcerebral venous catheter placement. Doppler flow probes were placed around the common ovine trunk, and the lambs underwent CV for 1 hour. Ventilation was adjusted to maintain physiologic blood gases. Pre- and postcerebral blood gas, glucose, and lactate samples were obtained every 15 minutes. Perfluorodecalin then was instilled endotracheally. The lambs underwent 1 hour of PLV with similar sampling. Data were analyzed using the Wilcoxon matched pairs test, significance at P ≤.05. Results: The authors observed no difference in mean QCAROTID or carotid vascular resistance between CV and PLV (P =.35 and.34, respectively). The CMR of oxygen, glucose, and lactate were calculated using the Fick principle. CMR was unchanged between modes (P =.5). Conclusions: PLV did not adversely alter QCAROTID or CMR in lambs, implying that this mode of ventilation should be safe in neonatal patients at risk for neurologic injury. J Pediatr Surg 37:840-844. Copyright 2002, Elsevier Science (USA). All rights reserved.