The efficacy of partial liquid ventilation on lung protection during hypotension and cardiac arrest

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Rationale : We previously reported that partial liquid ventilation (PLV) suppressed lung injury during cardiac arrest in the experimental rabbit model. We next investigated the efficacy of PLV in donor lung protection in lung transplantation from non-heart beating donors.Methods : We utilized eleven sets of female beagle dogs and divided into two groups : (a) conventional ventilation (GV, n=6), (b) partial liquid ventilation (PLV, n=5). While one-hour hypotension less than 50mmHg followed by 2-hour cardiac arrest was maintained, conventional ventilation or PLV had been performed for ventilation. Left donor lung retrieval and left single lung transplantation under conventional ventilation were performed. During the study period, arterial blood gas analysis, pulmonary resistance and elastance, and tissue Interleukin-8 (IL-8) concentration were serially measured. Donor lung histology was observed and assessed with histological evaluation scores. In 3 cases (GV:n=1, PLV:n=2) pulmonary resi … More stance and elastacne were measured even after the transplantation until the end of experiment.Results : There was no significant difference in arterial oxygen tension between the two groups during the study period. Histological evaluation score in both groups elevated gradually after transplantation, and the GV group showed its score at 6 hours after transplantation significantly higher than the PLV group. Pulmonary resistance and elastance gradually increased during the study period until lung retrieval, and there was no significant difference between the GV group and PLV group. IL-8 maintained its value as high as baseline level during the study period in both groups and there was no statistical difference between the two groups. According to the results of elastacne, resistance and histological evaluation score after the transplantation, there was correlation between histological scores and elastance or resistance.Conclusion : The histological analysis suggested PLV suppresses lung injury. There was correlation between the histological score and elastacne or resistance. And there is a possibility that the measurement of elastance or resistance might be one of the methods for the evaluation of lung injury. Less