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Long-term tidal liquid ventilation in premature lambs: physiologic, biochemical and histological correlates
Cynthia Cox1, Robert L Stavis, Marla R Wolfson
1Department of Neonatology, The Bryn Mawr Hospital, Bryn Mawr, PA, USA.
Insights
Tidal liquid ventilation (TLV) safely supports premature lambs for up to 72 hours, improving lung mechanics and gas exchange. This study demonstrates TLV
Area of Science:
- Neonatal Physiology
- Respiratory Medicine
- Liquid Ventilation
Background:
- Chronic lung disease remains a significant challenge in infants.
- Tidal liquid ventilation (TLV) is known to enhance lung mechanics and gas exchange.
Purpose of the Study:
- To evaluate the safety and efficacy of TLV in supporting preterm lambs for extended durations (up to 72 hours).
Main Methods:
- Nine preterm lambs (132 days gestation) were supported using TLV.
- Physiological parameters (pH, PaCO2, PaO2, compliance, blood pressure, heart rate) were monitored.
- Perflubron levels in blood and tissues were analyzed over the 72-hour period.
Main Results:
- Lambs maintained stable physiological parameters (pH 7.36, PaCO2 44 mmHg, PaO2 170 mmHg).
- Perflubron levels in tissues increased significantly from 24 to 72 hours (p<0.05).
- Tissue perflubron concentration correlated with lipid levels (r2=0.93, p<0.01).
Conclusions:
- Tidal liquid ventilation is a safe and effective method for supporting preterm lambs.
- TLV can be utilized for up to 72 hours in this preclinical model.
- Understanding perflubron distribution in tissues is crucial for long-term applications.
Abstract:
Chronic lung disease in infants continues to be problematic. Tidal liquid ventilation (TLV) improves lung mechanics and provides effective gas exchange. We hypothesized that premature lambs could be supported safely with TLV and evaluated 9 preterm lambs (132 days gestation) on TLV up to 72 h. Results (mean +/- SEM): pH 7.36 +/- 0.003, PaCO2 44 +/- 0.34 mm Hg, PaO2 170 +/- 4.8 mm Hg, compliance=1.65 +/- 0.24 ml/cm H2O/kg, mean arterial blood pressure=53 +/- 0.08 mm Hg, heart rate=189 +/- 1.5 bpm. Blood perflubron levels were 6.0 +/- 0.24 microg/ml over 24 h. Tissue perflubron levels increased from 81 +/- 7.0 microg/g at 24 h to 108 +/- 15 microg/g at 72 h (p<0.05). There was a difference in perflubron concentrations as a function of tissue (p<0.001) that correlated to lipid levels (r2=0.93, p<0.01). These data demonstrate that TLV is both safe and effective up to 72 h in premature lambs.