Partial Liquid Ventilation in Adult Patients with Acute Respiratory Distress Syndrome

Abstract

PLV at both high and low doses did not improve outcome in ARDS compared with CMV and cannot be recommended for patients with ARDS.

Aerosolized perfluorocarbon improves gas exchange and pulmonary mechanics in preterm lambs with severe respiratory distress syndrome

“…On the other hand, because the study was focused on the efficacy of aerosolized PFC, the control group was composed of untreated animals, which significantly differs from a clinical setting, where the subjects would almost certainly be spontaneously breathing. Future studies should elucidate whether aerosolized PFC is superior to PLV in preterm lambs, as previously found in a pediatric porcine model with surfactant depletion (1), and whether this therapeutic approach can avoid the "peridosing" adverse effects associated with PLV (11,30). The potential additive effect of aerosolized PFC to surfactant therapy should be explored as well, as it has been demonstrated for PLV (31).…”

“…The benefits of intratracheally instilled PFC for respiratory support are well known (2-10). However, clinical trials have failed to demonstrate the superiority of PLV over standard care (11).…”

“…In this technique, the lungs are filled with PFC to their functional residual capacity, and tidal volumes of gas are exchanged with a conventional mechanical ventilator. Although this technique has shown promising results in various animal models of lung injury (2-4,7-10), clinical trials have failed to demonstrate that PLV is better than standard care for the treatment of acute RDS (11).…”

Inhalation of Nebulized Perfluorochemical Enhances Recombinant Adenovirus and Adeno-Associated Virus-Mediated Gene Expression in Lung Epithelium

“…Perfluorochemical (PFC) liquids are inert, nontoxic liquids that had been extensively investigated for use in preclinical models of lung injury and in clinical application of partial liquid ventilation (PLV) for diseased lungs (Leach et al, 1996;Hirschl et al, 2002;Kacmarek et al, 2006). Although liquid ventilation has generally fallen from clinical use, administration of perflubron (LiquiVent; Alliance Pharmaceutical, San Diego, CA) and other PFC liquids in PLV was safe and could improve oxygenation and lung mechanics while also decreasing histopathological injury and inflammation in injured lungs (Hirschl et al, 1995(Hirschl et al, , 2002Leach et al, 1996;Rotta et al, 1999;Kacmarek et al, 2006).…”

“…Although liquid ventilation has generally fallen from clinical use, administration of perflubron (LiquiVent; Alliance Pharmaceutical, San Diego, CA) and other PFC liquids in PLV was safe and could improve oxygenation and lung mechanics while also decreasing histopathological injury and inflammation in injured lungs (Hirschl et al, 1995(Hirschl et al, , 2002Leach et al, 1996;Rotta et al, 1999;Kacmarek et al, 2006). More recently it has been found that inhalation of nebulized perflubron and other PFC compounds comparably enhances oxygenation and improves lung mechanics in preclinical models of lung injury (Bleyl et al, 1999;Kandler et al, 2001Kandler et al, , 2004Ragaller et al, 2001;von der Hardt et al, 2004;Gama de Abreu et al, 2005;Meinhardt et al, 2005).…”