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Am J Respir Crit Care Med. 2006 Apr 15;173(8):882-9. Epub 2005 Oct 27.

Partial liquid ventilation in adult patients with acute respiratory distress syndrome.

Author information

  • 1Department of Anesthesia and Critical Care, Harvard Medical School, and Respiratory Care, Massachusetts General Hospital, Boston, MA 02114, USA. rkacmarek@partners.org

Abstract

RATIONALE:

Despite recent clinical trials demonstrating improved outcome in acute respiratory distress syndrome (ARDS), mortality remains high. Partial liquid ventilation (PLV) using perfluorocarbons has been shown to improve oxygenation and decrease lung injury in various animal models.

OBJECTIVE:

To determine if PLV would have an impact on outcome in patients with ARDS.

METHODS:

Patients with ARDS were randomized to (1) conventional mechanical ventilation (CMV; n=107), (2) "low-dose" perfluorocarbon (10 ml/kg; n=99), and (3) "high-dose" perfluorocarbon (20 ml/kg; n=105). Patients in all three groups were ventilated using volume ventilation, Vt <or= 10 ml/kg predicted body weight, rate <or= 25/min, inspiratory-to-expiratory ratio <or= 1:1, Fi(O(2)) >or= 0.5, and positive end-expiratory pressure >or= 13 cm H(2)O.

RESULTS:

The 28-d mortality in the CMV group was 15%, versus 26.3% in the low-dose (p=0.06) and 19.1% in the high-dose (p=0.39) PLV groups. There were more ventilator-free days in the CMV group (13.0+/-9.3) compared with both the low-dose (7.4+/-8.5; p<0.001) and high-dose (9.9+/-9.1; p=0.043) groups. There were more pneumothoraces, hypoxic episodes, and hypotensive episodes in the PLV patients.

CONCLUSIONS:

PLV at both high and low doses did not improve outcome in ARDS compared with CMV and cannot be recommended for patients with ARDS.

Comment in

PMID:
16254269
[PubMed - indexed for MEDLINE]
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