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Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism

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Published on: February 14, 2022

Ventilation-perfusion ratio in perflubron during partial liquid ventilation.

Alexander-Wigbert K Scholz¹, Balthasar Eberle, Claus P Heussel

¹Department of Anesthesiology, Johannes Gutenberg-University, Langenbeckstrasse 1, 55131 Mainz, Germany. ascholz@uni-mainz.d

Anesthesia and Analgesia

|May 8, 2010

Summary

Functional MRI of fluorine-19 can map oxygen levels in the lungs. This method, combined with the Fick principle, quantifies lung ventilation-perfusion ratio (Va/Q) during liquid ventilation, revealing oxygen transport limitations.

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Phase-Resolved Functional Lung MRI for Pulmonary Ventilation and Perfusion (V/Q) Assessment

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Area of Science:

Physiology
Medical Imaging
Biomedical Engineering

Background:

Functional magnetic resonance imaging (fMRI) using fluorine-19 enables mapping of oxygen partial pressure (Pao(2)) in perfluorocarbons within the alveolar space.
Theoretically, Pao(2) measurements from fMRI can be integrated with the Fick principle to determine the ventilation-perfusion ratio (Va/Q) of lung regions.

Purpose of the Study:

To investigate the feasibility of quantifying local Va/Q using fMRI-detected Pao(2) and the Fick principle.
To apply this method for Va/Q estimation during partial liquid ventilation in an animal model.

Main Methods:

Numerical simulations were conducted to assess the sensitivity of the Va/Q calculation and compare it with existing methods.
The approach was experimentally validated in anesthetized pigs undergoing partial liquid ventilation with perflubron.
Fluorine-19 MRI measured Pao(2) distribution, while respiratory gas fractions and blood samples quantified oxygen levels to estimate local Va/Q via the Fick principle.

Main Results:

Numerical simulations confirmed the Fick principle's appropriateness for Va/Q calculation across a wide range.
Experimental results in pigs showed low mean Va/Q values in perflubron-filled lungs, particularly with higher perflubron doses.
A significant difference in Va/Q was observed between nondependent and dependent lung regions, with higher Va/Q in nondependent areas.

Conclusions:

The study demonstrates the feasibility of deriving Va/Q from local Pao(2) measurements using fMRI in perflubron.
The consistently low Va/Q values indicate significant constraints on oxygen transport into the perflubron-filled alveolar space.