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Preserved spontaneous breathing improves cardiac output during partial liquid ventilation
A R Franz1, C Mack, J Reichart
1Department of Pediatrics, Division of Neonatology and Pediatric Critical Care, University of Ulm, Ulm, Germany. axel.franz@medizin.uni-ulm.de
Summary
Preserved spontaneous breathing (SB) with proportional-assist ventilation (PAV) improved cardiac output (CO) during partial liquid ventilation (PLV) compared to controlled ventilation with muscle paralysis. This enhanced oxygen delivery, particularly in rabbits with lung disease.
Area of Science:
- Critical care medicine
- Respiratory physiology
- Neonatal respiratory support
Background:
- Partial liquid ventilation (PLV) is an experimental lung protective strategy.
- Mechanical ventilation modes impact cardiorespiratory function.
- Optimizing ventilation is crucial for oxygen delivery, especially in lung disease.
Purpose of the Study:
- To compare cardiac output (CO) during preserved spontaneous breathing (SB) with proportional-assist ventilation (PAV) versus controlled ventilation (CV) with muscle paralysis (MP) during PLV.
- To assess the impact of these ventilatory modes on oxygen delivery in healthy and surfactant-depleted rabbits.
Main Methods:
- A crossover study design was used in 17 healthy and 17 surfactant-depleted rabbits.
- Partial liquid ventilation (PLV) was induced using perfluorodecaline.
- Cardiac output (CO) was measured via thermodilution under both SB+PAV and CV+MP conditions.
Main Results:
- SB+PAV significantly increased CO compared to CV+MP in both healthy (136 vs. 120 ml/kg/min) and surfactant-depleted rabbits (147 vs. 111 ml/kg/min).
- Improved CO during SB+PAV was primarily due to increased stroke volume.
- In surfactant-depleted rabbits, SB+PAV also improved blood pressure, pH, and PaO2.
Conclusions:
- Preserved spontaneous breathing (SB) with proportional-assist ventilation (PAV) enhances cardiac output (CO) and oxygen delivery during partial liquid ventilation (PLV).
- SB+PAV is a potentially superior ventilatory strategy compared to controlled ventilation with muscle paralysis, especially in compromised lung states.