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Neonates with congenital diaphragmatic hernia: radiographic findings during partial liquid ventilation
K A Garver1, E A Kazerooni, R B Hirschl
1Department of Radiology, C.S. Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor 48109-0252, USA.
Purpose:
To determine the serial radiographic appearance of the lungs of neonates who underwent partial liquid ventilation with perflubron because of congenital diaphragmatic hernia (CDH) or primary pulmonary hypertension.
Materials And Methods:
Bedside anteroposterior (AP) and lateral chest radiographs (n = 235) were scored for percentage of lung opacification by perflubron during partial liquid ventilation (PLV) and extracorporeal membrane oxygenation (ECMO). Five neonates participated in the study; four had CDH, and one had primary pulmonary hypertension.
Results:
The lungs were opacified nearly completely after each dose of perflubron. The degree of opacification was the same on 117 of 169 (69%) AP radiographs and within one point on another 40 (24%). A gravity-dependent distribution was shown on 58 of 66 (88%) lateral radiographs. A minimal amount of perflubron remained in the lungs after 5.2 days. A hypoplastic bronchus and ipsilateral lung were manifest in all four of the patients with CDH after the airway and lung were filled with radiopaque perflubron.
Conclusion:
Lungs filled with perflubron were opacified to a similar degree in a gravity-dependent distribution. Evaporation of perflubron from the lungs of neonates is relatively rapid. The size of the ipsilateral bronchus and lung may be estimated by comparison of radiographs taken before and after the lungs were filled with perflubron.