Total Liquid Ventilation Improves Oxygenation in an Experimental Model of Acute Respiratory Distress Syndrome
KLIMOVIČ M., FEDORA M., ŠEDA M., DOMINIK P., NEKVASIL R.
ARO FN Brno, Dětská nemocnice, přednosta prim. MUDr. Michal Klimovič, ECMO centrum FN Brno, Dětská nemocnice, vedoucí doc. MUDr. Roman Nekvasil, CSc. |
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Summary:
Objective: To assess gas exchange during total liquid ventilation (TLV) in an experimental model of acute respiratory distress syndrome (ARDS).
Type of study: Laboratory experiment on animal model.
Setting: The laboratory of experimental pathophysiology, Medical Faculty, Masaryk University, Brno.
Subjects: 12 laboratory animals rabbits.
Method: After premedication, tracheostomy was performed in all animals. EKG, central venous pressure and arterial pressure were monitored.
After conventional mechanical ventilation rabbits were randomly allocated into two groups: 1 st group with intact lungs and 2nd group with experimental
ARDS. The animals in the 1st group were ventilated with total liquid ventilation, followed by conventional mechanical ventilation. ARDS was induced
by wash-out of lungs with normal saline in the animals in the 2nd group. After period of total liquid ventilation, conventional mechanical ventilation
followed. All phases of the experiment lasted 60 minutes. We monitored heart rate, acid-base balance, blood gases, central venous pressure and blood
pressure in 5 minutes interval; the values were compared at the end of each period.
Results: Group 1: the decrease in pH during liquid ventilation (LV) persisted after the period of LV (statistically significant), the rise of paCO2
during LV and the decrease after LV were statistically significant. The decrease of paO2/FiO2 during LV and its increase after LV was also statistically
significant. Group 2: pH decreased during lung lavage and subsequently during LV (all statistically significant), paCO2 increased during lavage and
subsequently during LV (statistically significant) with the decrease after LV. paO2/FiO2 after the decrease during lavage rised during LV and
subsequently decreased after LV period (all statistically significant).
Conclusion: TLV can improve oxygenation after experimentally induced ARDS; hypercapnia and acidosis persist. In healthy lungs, however,
oxygenation and ventilation are compromised; the changes are reversible.
Key words:
total liquid ventilation - acid-base balance - blood gases - ARDS - experiment
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