Small-dose perfluorocarbon reduces the recruitment pressure needed to open surfactant-deficient atelectatic lungs

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BackgroundThis study was undertaken to investigate the effect of a small dose of perfluorocarbon on the recruitment pressure needed to open atelectatic lung areas.MethodsIn 12 Yorkshire pigs (body weight, 9 kg), lung injury was induced by whole lung lavage. After 1 h of conventional ventilation, an open lung maneuver was performed to obtain PaO2 values equal to the pre-lavage PaO2 values (±10%). After 1 h of ventilation at the lowest possible airway pressure that stabilized the recruited lung volume, the animals were disconnected from the ventilator to allow the lung to collapse. Six animals received a 5 ml/kg intratracheal dose of perfluorocarbon and a second open lung maneuver was performed. Six animals served as controls and received no perfluorocarbon but also underwent a second open lung maneuver.ResultsIn both groups, an open lung maneuver resulted in a significant increase in oxygenation. The peak pressures needed to open the lung after 1 h of mechanical ventilation in the perfluorocarbon and control groups were 43.8 ± 8.4 cmH2O and 46.6 ± 4 cmH2O, respectively. The addition of perfluorocarbon significantly reduced the opening pressure to 34.5 ± 6.3 cmH2O (P < 0.01), whereas the opening pressure in the control group, 45.0 ± 0.2 cmH2O, did not change.ConclusionThe instillation of a small amount of perfluorocarbon significantly reduces the opening pressures needed to recruit atelectatic lung areas.

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