Delayed partial liquid ventilation shows no efficacy in the treatment of smoke inhalation injury in swine

• Published in: Journal of applied physiology (1985) Vol. 90; no. 6; pp. 2351 - 2360
• Main Authors: Harrington, D. T, Jordan, B. S, Dubick, M. A, Cancio, L. C, Brinkley, W, Kim, S, Burleson, D. G, Delgado, A, Goodwin, C. W
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Am Physiological Soc 01.06.2001; American Physiological Society
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Blood Gas Analysis; Disease Models, Animal; Emergency and intensive respiratory care; Female; Flow Cytometry; Fluids; Fluorocarbons; Hemodynamics - physiology; Hogs; Injuries; Intensive care medicine; Liquid Ventilation; Lung - pathology; Lung Compliance - physiology; Male; Medical sciences; Mucous Membrane - pathology; Organ Size - physiology; Respiratory Function Tests; Respiratory therapy; Smoke inhalation; Smoke Inhalation Injury - pathology; Smoke Inhalation Injury - physiopathology; Smoke Inhalation Injury - therapy; Survival Analysis; Swine; Time Factors; Animal model; Assisted ventilation; Liquid ventilation; Respiratory disease; Organic perhalocompound; Fluorocarbon; Artificial ventilation; Compliance(volume pressure); Survival; Inhalation; Pig; Vertebrata; Mammalia; Treatment; Animal; Artiodactyla; Oxygenation; Fumes; Ungulata
• ISSN: 8750-7587; 1522-1601
• DOI: 10.1152/jappl.2001.90.6.2351

United States Army Institute of Surgical Research, Fort Sam Houston, Texas 78234 In an earlier neonatal porcine model of smoke inhalation injury (SII), immediate postinjury application of partial liquid ventilation (PLV) had dramatic beneficial effects on lung compliance, oxygenation, and survival over a 24-h period. To explore the efficacy of PLV following SII, we treated animals at 2 and 6 h after SII and followed them for 72 h. Pigs weighing 8-12 kg were sedated and pharmacologically paralyzed, given a SII, and placed on volume-cycled, pressure-limited ventilation. Animals were randomized to three groups: group I (+SII, no PLV, n  = 8), group II (+SII, PLV at 2 h, n  = 6), and group III (+SII, PLV at 6 h, n  = 7). Ventilatory parameters and arterial blood gasses were obtained at scheduled intervals. The PLV animals ( groups II and III ) followed a worse course than group I (no PLV); PLV groups had higher peak and mean airway pressures, oxygenation index, and rate-pressure product (a barotrauma index) and lower lung compliance and arterial partial pressure of oxygen-to-inspired oxygen fraction ratio (all P  <   0.05). PLV conferred no survival advantage. The reported beneficial effects of PLV with other models of acute lung injury do not appear to extend to the treatment of SII when PLV is instituted in a delayed manner. This study was not able to validate the previously reported beneficial effects of PLV in SII and actually found deleterious effects, perhaps reflecting the predominance of airway over alveolar disease in SII. barotrauma; perfluorocarbon; pigs