Introduction: Partial liquid ventilation may benefit the lung disease in preterm neonates but intratracheal instillation of perfluorocarbon increases cerebral blood flow and may cause brain injury. We aimed to determi...Introduction: Partial liquid ventilation may benefit the lung disease in preterm neonates but intratracheal instillation of perfluorocarbon increases cerebral blood flow and may cause brain injury. We aimed to determine if the effects of perfluorocarbon administration on cerebral blood flow vary by dose-volume, rate of administration, endotracheal tube portal of entry, or closely targeting PaCO2. Methods: Forty-two dosing events (in eleven rabbits) were randomised to different dosing strategies, including a sham (i.e., placebo/control) dose of air over 20 min, 20 mL/kg of perfluorocarbon slowly over 20 min, 10 mL/kg of perfluorocarbon slowly over 20 min, 10 mL/kg of perfluorocarbon moderately fast over 10 min, 10 mL/kg of perfluorocarbon rapidly over 5 min, 10 mL/kg of perfluorocarbon slowly over 20 min via the endotracheal tube tip lumen (as opposed to the proximal end of the tube used in all other groups), or 10 mL/kg of perfluorocarbon slowly over 20 min whilst targeting a PaCO2 of 45 - 50 mmHg. Blood gases, haemodynamics, cortical cerebral blood flow and carotid flow were recorded continuously for 30 minutes from the start of each dose. Results: Carotid flow increased with 20 mL/kg perfluorocarbon and cortical cerebral blood flow was significantly more variable. Carotid and cortical cerebral blood flow increased using 10 mL/kg or 20 mL/kg with no difference between the two dose-volumes. There was no difference in cerebral blood flow by rate of administration, but carotid blood flow was more variable during slow administration. There were no differences in the increase in cerebral blood flow by portal of entry. If PaCO2 was maintained between 45 - 50 mmHg there was no increase in cerebral blood flow and there was less variable carotid flow. Conclusions: Cerebral blood flow increases with perfluorocarbon dosing. This occurs regardless of the dose-volume of perfluorocarbon. These effects were mitigated by closely targeting PaCO2.展开更多
Background Pediatric patients are susceptible to lung injury.Acute lung injury （ALI） in children often results in a high mortality.Partial liquid ventilation （PLV） has been shown to markedly improve oxygenation an...Background Pediatric patients are susceptible to lung injury.Acute lung injury （ALI） in children often results in a high mortality.Partial liquid ventilation （PLV） has been shown to markedly improve oxygenation and reduce histologic evidence of injury in a number of lung injury models.This study aimed to examine the hypothesis that PLV would attenuate the production of local and systemic cytokines in an immature piglet model of ALI induced by oleic acid （OA）.Methods Twelve Chinese immature piglets were induced to develop ALI by oleic acid.The animals were randomly assigned to two groups （n=6）： （1） conventional mechanical ventilation （MV） group and （2） PLV with FC-77 （10 ml/kg） group.Results Compared with MV group, PLV group got better cardiopulmonary variables （P 〈0.05）.These variables included heart rate, mean blood pressure, blood pH, partial pressure of arterial oxygen （PaO2）, PaO2/FiO2 and partial pressure of arterial carbon dioxide （PaCO2）.Partial liquid ventilation reduced IL-1β, IL-6, IL-10 and TN F-α both in plasma and tissue concentrations compared with MV group （P 〈0.05）.Conclusions Partial liquid ventilation provides protective effects against inflammatory responses in the lungs of oleic acid-induced immature piglets.展开更多
Background Pediatric patients are susceptible to lung injury.Acute lung injury in children often results in high mortality.Partial liquid ventilation （PLV） has been shown to markedly improve oxygenation and reduce h...Background Pediatric patients are susceptible to lung injury.Acute lung injury in children often results in high mortality.Partial liquid ventilation （PLV） has been shown to markedly improve oxygenation and reduce histologic evidence of injury in a number of lung injury models.This study was designed to examine the hypothesis that PLV would attenuate the production of local and systemic tumor necrosis factor （TNF）-α in an immature piglet model of acute lung injury induced by oleic acid （OA）.Methods Twelve Chinese immature piglets were induced acute lung injury by OA.The animals were randomly assigned to two groups of six animals,（1） conventional mechanical ventilation （MV） group and （2） PLV with 10 ml/kg FC-77 group.Results Compared with MV group,the PLV group had better cardiopulmonary variables （P 〈0.05）.These variables included heart rate,mean blood pressure,blood pH,partial pressure of arterial oxygen （PaO2）,PaO2/inspired O2 fraction （FiO2） and partial pressure of arterial carbon dioxide （PaCO2）.PLV reduced TNF-α levels both in plasma and tissue compared with MV group （P 〈0.05）.Conclusion PLV provides protective effects against TNF-a response in OA-induced acute lung injury in immature piglets.展开更多
Background Pediatric patients are susceptible to lung injury that does not respond to traditional therapies.Partial liquid ventilation （PLV） has been developed as an alternative ventilatory strategy for treating sev...Background Pediatric patients are susceptible to lung injury that does not respond to traditional therapies.Partial liquid ventilation （PLV） has been developed as an alternative ventilatory strategy for treating severe lung injury.The aim of this study is to investigate the effect of PLV on lung function in immature piglets.Methods Acute lung injury was induced in 12 Chinese immature piglets by oleic acid （OA）.The animals were randomly assigned to two groups （n=6 each group）：（1） conventional mechanical ventilation （MV） group and （2） PLV with FC-77 （10 ml/kg） group.Mean arterial blood pressure （MAP）,mean pulmonary arterial pressure （MPAP）,central venous pressure （CVP）,left atrial pressure （LAP）,systemic vascular resistance （SVR）,pulmonary vascular resistance （PVR）,cardiac output （CO）,mean pressure of airway （Paw）,dynamic lung compliance （Cydn）,and arterial blood gases were measured during the observation period.Results No piglet died in either group with severe lung injury.After four hours of ventilation,pH in the MV group gradually decreased to lower than 7.20,while in the PLV group,pH also gradually decreased but remained higher than 7.20 （P ＜0.05）.Partial pressure of oxygen in artery （PaO2） decreased in both groups,but with a significant difference between the PLV group and MV group （P ＜0.05）.Partial pressure of carbon dioxide in artery （PaCO2） increased in both groups,but with a significant difference between the PLV group and MV group （P ＜0.05）.Paw increased in both groups,but was not significantly different （P ＞0.05）.Cydn decreased in both groups,but without a significant difference （P ＞0.05）.At four hours,heart rate （HR） and MAP in both groups decreased.MPAP in both groups increased,and there was a significant difference between the two groups （P ＜0.05）.CVP was stable in both groups.At four hours,PVR and LAP were increased in both groups.CO was decreased in both groups （P ＜0.05）.SVR was stable during the observation time.Conclusion PLV did not improve outcome in changes of lung function.展开更多
目的观察部分液体通气(partial liqu id ventilation,PLV)联合气道内给予血管扩张药伊洛前列素对急性肺损伤(acute lung in jury,ALI)兔肺气体交换、肺力学方面的影响。方法健康大白兔24只,用油酸混合兔血清复制成ALI模型后随机分为3组...目的观察部分液体通气(partial liqu id ventilation,PLV)联合气道内给予血管扩张药伊洛前列素对急性肺损伤(acute lung in jury,ALI)兔肺气体交换、肺力学方面的影响。方法健康大白兔24只,用油酸混合兔血清复制成ALI模型后随机分为3组。各组采用不同治疗方法:常规机械通气组(conventionalm echan ical ventilation,CMV);部分液体通气组(PLV);联合组为PLV+雾化吸入伊洛前列素(iloprost)。分别监测各组治疗前后各时相点PaO2、PaCO2及肺静态顺应性(Cstat)、肺动脉平均压(pu lmonary arterial pressure,PAP)的变化。结果联合组PaO2从(104±16)mmHg升高到(236±38)mmHg(P<0.05),肺动脉平均压从(22±5)mmHg降低到(16±3)mmHg(P<0.05)。联合组PaO2的升高及PAP的降低优于CMV组和PLV组。结论部分液体通气联合雾化吸入伊洛前列素不仅对于改善ALI肺氧合功能优于单纯部分液体通气,还可减低部分液体通气对肺血流动力学的影响,降低肺动脉高压。展开更多
文摘Introduction: Partial liquid ventilation may benefit the lung disease in preterm neonates but intratracheal instillation of perfluorocarbon increases cerebral blood flow and may cause brain injury. We aimed to determine if the effects of perfluorocarbon administration on cerebral blood flow vary by dose-volume, rate of administration, endotracheal tube portal of entry, or closely targeting PaCO2. Methods: Forty-two dosing events (in eleven rabbits) were randomised to different dosing strategies, including a sham (i.e., placebo/control) dose of air over 20 min, 20 mL/kg of perfluorocarbon slowly over 20 min, 10 mL/kg of perfluorocarbon slowly over 20 min, 10 mL/kg of perfluorocarbon moderately fast over 10 min, 10 mL/kg of perfluorocarbon rapidly over 5 min, 10 mL/kg of perfluorocarbon slowly over 20 min via the endotracheal tube tip lumen (as opposed to the proximal end of the tube used in all other groups), or 10 mL/kg of perfluorocarbon slowly over 20 min whilst targeting a PaCO2 of 45 - 50 mmHg. Blood gases, haemodynamics, cortical cerebral blood flow and carotid flow were recorded continuously for 30 minutes from the start of each dose. Results: Carotid flow increased with 20 mL/kg perfluorocarbon and cortical cerebral blood flow was significantly more variable. Carotid and cortical cerebral blood flow increased using 10 mL/kg or 20 mL/kg with no difference between the two dose-volumes. There was no difference in cerebral blood flow by rate of administration, but carotid blood flow was more variable during slow administration. There were no differences in the increase in cerebral blood flow by portal of entry. If PaCO2 was maintained between 45 - 50 mmHg there was no increase in cerebral blood flow and there was less variable carotid flow. Conclusions: Cerebral blood flow increases with perfluorocarbon dosing. This occurs regardless of the dose-volume of perfluorocarbon. These effects were mitigated by closely targeting PaCO2.
基金This study was supported by National Natural Science Foundation of China （No. 30670928）
文摘Background Pediatric patients are susceptible to lung injury.Acute lung injury （ALI） in children often results in a high mortality.Partial liquid ventilation （PLV） has been shown to markedly improve oxygenation and reduce histologic evidence of injury in a number of lung injury models.This study aimed to examine the hypothesis that PLV would attenuate the production of local and systemic cytokines in an immature piglet model of ALI induced by oleic acid （OA）.Methods Twelve Chinese immature piglets were induced to develop ALI by oleic acid.The animals were randomly assigned to two groups （n=6）： （1） conventional mechanical ventilation （MV） group and （2） PLV with FC-77 （10 ml/kg） group.Results Compared with MV group, PLV group got better cardiopulmonary variables （P 〈0.05）.These variables included heart rate, mean blood pressure, blood pH, partial pressure of arterial oxygen （PaO2）, PaO2/FiO2 and partial pressure of arterial carbon dioxide （PaCO2）.Partial liquid ventilation reduced IL-1β, IL-6, IL-10 and TN F-α both in plasma and tissue concentrations compared with MV group （P 〈0.05）.Conclusions Partial liquid ventilation provides protective effects against inflammatory responses in the lungs of oleic acid-induced immature piglets.
基金This study was supported by the grants from National Natural Science Foundation of China （No. 30670928 and No. 81070055）, Beijing Municipal Education Commission （No. PXM2011_014226 07 000060）, Beijing Municipal Science Committee （No. Z11110006150000） and Beijing Natural Science Foundation （No. 7122056）.We are grateful to Dr. LING Feng, Dr. LIU Ai-jun, Dr. LI Gang and Dr. XU Yu-lin for their preparation of the animals, to Dr. LIU Yang-qing and Dr. LIU De-bin for their histopathological assessment.
文摘Background Pediatric patients are susceptible to lung injury.Acute lung injury in children often results in high mortality.Partial liquid ventilation （PLV） has been shown to markedly improve oxygenation and reduce histologic evidence of injury in a number of lung injury models.This study was designed to examine the hypothesis that PLV would attenuate the production of local and systemic tumor necrosis factor （TNF）-α in an immature piglet model of acute lung injury induced by oleic acid （OA）.Methods Twelve Chinese immature piglets were induced acute lung injury by OA.The animals were randomly assigned to two groups of six animals,（1） conventional mechanical ventilation （MV） group and （2） PLV with 10 ml/kg FC-77 group.Results Compared with MV group,the PLV group had better cardiopulmonary variables （P 〈0.05）.These variables included heart rate,mean blood pressure,blood pH,partial pressure of arterial oxygen （PaO2）,PaO2/inspired O2 fraction （FiO2） and partial pressure of arterial carbon dioxide （PaCO2）.PLV reduced TNF-α levels both in plasma and tissue compared with MV group （P 〈0.05）.Conclusion PLV provides protective effects against TNF-a response in OA-induced acute lung injury in immature piglets.
基金This study was supported by grants from the National Natural Science Foundation of China （No. No. 81070055, No. 81371443）, Beijing Science and Technology Commission （No. Z 1111000749 l 1001）, Beijing Natural Science Foundation （No. 7112046, No. 7122056）, Beijing Health System High Level Health Technical Personnel Training Plan （No. 2011-1-4） and Basic and Clinical Cooperation Project of Capital Medical University （No. 13JL26）.
文摘Background Pediatric patients are susceptible to lung injury that does not respond to traditional therapies.Partial liquid ventilation （PLV） has been developed as an alternative ventilatory strategy for treating severe lung injury.The aim of this study is to investigate the effect of PLV on lung function in immature piglets.Methods Acute lung injury was induced in 12 Chinese immature piglets by oleic acid （OA）.The animals were randomly assigned to two groups （n=6 each group）：（1） conventional mechanical ventilation （MV） group and （2） PLV with FC-77 （10 ml/kg） group.Mean arterial blood pressure （MAP）,mean pulmonary arterial pressure （MPAP）,central venous pressure （CVP）,left atrial pressure （LAP）,systemic vascular resistance （SVR）,pulmonary vascular resistance （PVR）,cardiac output （CO）,mean pressure of airway （Paw）,dynamic lung compliance （Cydn）,and arterial blood gases were measured during the observation period.Results No piglet died in either group with severe lung injury.After four hours of ventilation,pH in the MV group gradually decreased to lower than 7.20,while in the PLV group,pH also gradually decreased but remained higher than 7.20 （P ＜0.05）.Partial pressure of oxygen in artery （PaO2） decreased in both groups,but with a significant difference between the PLV group and MV group （P ＜0.05）.Partial pressure of carbon dioxide in artery （PaCO2） increased in both groups,but with a significant difference between the PLV group and MV group （P ＜0.05）.Paw increased in both groups,but was not significantly different （P ＞0.05）.Cydn decreased in both groups,but without a significant difference （P ＞0.05）.At four hours,heart rate （HR） and MAP in both groups decreased.MPAP in both groups increased,and there was a significant difference between the two groups （P ＜0.05）.CVP was stable in both groups.At four hours,PVR and LAP were increased in both groups.CO was decreased in both groups （P ＜0.05）.SVR was stable during the observation time.Conclusion PLV did not improve outcome in changes of lung function.
