Efficacy of perfluorocarbon partial liquid ventilation in a large animal model of acute respiratory failure

Objective: To demonstrate the efficacy of partial perfluorocarbon liquid ventilation in a large animal model of acute respiratory failure. Design: Prospective, randomized, controlled trial. Setting: Animal laboratory at a university medical center. Subjects: Ten adult sheep, weighing 53.0 +/- 2.8 kg. Interventions: After assessment of baseline physiologic data, acute respiratory failure was induced by right atrial injection of oleic acid (0.2 mL/kg). Five animals (partial liquid ventilation group) underwent sequential intratracheal dosing of 10 mL/kg of perflubron at 30-min intervals to the following cumulative doses: 10, 20, 30, 40, and 50 mL/kg. The remaining five animals were gas ventilated (control group). Physiologic data were assessed at 30-min intervals in both groups for the 2.5-hr experimental period or until death. Measurements and Main Results: When compared with control animals, intratracheal perfluorocarbon instillation resulted in significant improvements in arterial oxygen saturation (arterial oxygen saturation after 50 mL/kg: partial liquid ventilation, 96 +/- 3%; control, 55 +/- 8%; p = .001)and physiologic shunt (physiologic shunt after 50 mL/kg dose: partial liquid ventilation, 22 +/- 8%; control, 64 +/- 5%; p = .004). Oxygen delivery improved with perfluorocarbon instillation, but this improvement was not significant. No significant difference in pulmonary compliance was observed during partial liquid ventilation when compared with controls (pulmonary compliance: partial liquid ventilation, 0.43 +/- 0.04 mL/cm H2O/kg; control, 0.53 +/- 0.03 mL/cm H2O/kg; p = .102). Conclusions: Partial liquid ventilation with perflubron provides effective improvement in gas exchange in an adult animal model of respiratory failure.