Liquid Ventilation
I History of Liquid Ventilation
A The first successful use of total liquid ventilation was in dogs in 1966.
B During this period liquid ventilation was researched in the hope that individuals would be able to remain under water for long periods with respiration supported by a fluid media.
C The first fluid used for liquid ventilation was saline.
D Fuhrman first described partial liquid ventilation in 1991.
E The first reported series of patients (neonates) maintained with partial liquid ventilation was in 1996.
F The last randomized controlled trial of partial liquid ventilation in adults was completed in 2001.
II Definitions and Descriptions
1. The movement of a liquid into and out of the lungs with each breath.
2. This is accomplished with a system similar to an extracorporeal membrane oxygenation system.
3. A gas exchanger, heater, and pump are necessary.
4. Total liquid ventilation systems have only been used on animal models; no patient has ever been maintained with a total liquid ventilation system.
1. The lung is filled with a liquid to approximately 50% to 100% of functional residual capacity (FRC).
2. On top of the liquid the patient is conventionally mechanically ventilated.
3. Partial liquid ventilation is the only approach ever used in patients.
1. Carbon-based chemicals are used as the liquid media for all approaches to liquid ventilation.
2. A number of different perfluorocarbons have been used in animal models, but only one, Perflubron (C8F17 Br; Alliance Pharmaceuticals, San Diego, CA) has been used in patients.
3. Box 46-1 lists the physical properties of Perflubron.
4. Other perfluorocarbons used for liquid ventilation include
III Mechanisms of Action of Perflubron
1. Because Perflubron has a high density it prevents fluid and protein from moving across the alveolar capillary membrane into the lung.
