Real-time visualization of partial liquid ventilation

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Acute lung inury rat model were induced by tracheal instillation of not endotoxin but hydrochloric acid in this study, because endotoxin could not always induce lung injury in each rat model. To clarify an efficacy of partial liquid ventilation in the treatment of acute lung injury, we visualized and morphologically analyzed real-time alveolar recruitment in a rat lung injury model.Male Wistar rats were divided into three groups : a group that underwent hydrochloric acid aspiration and mechanical gas ventilation (ALI, n=10), a group that underwent hydrochloric acid aspiration and partial liquid ventilation with perfluorocarbon beginning 90 mins after acid aspiration (PLV, n=10), and a group that did not undergo acid aspiration but that did undergo mechanical gas ventilation (Control, n=5). The average number of alveoli and the diameter of the largest functional alveoli in 10 high-power fields (1080 x 790 um) observed on fluorescence micrographs labeled albumin as a tracer, were measure … More d every 30 mins from 90 to 210 mins after the acid aspiration. Results showed that alveolar recruitment was marked immediately after partial liquid ventilation. Functional alveoli per high-power field decreased significantly in the ALI group (31.2±8.9), in comparison to that in the Control group (144±11.9). The number in the PLV group increased to 102.1±17.6 at 30 mins after partial liquid ventilation and to 130.3±19.1 until the end of the experiment. The diameter of the largest functional alveolus decreased from 103.7±16.3 um under mechanical gas ventilation before liquid ventilation to 86.5±7.4 um at 30mins after liquid ventilation. This value decreased further and remained constant until the end of the experiment at 76.3±6.5 um, which was equivalent to that in the Control group (75.1±9.4 um). Wet to dry lung weight ratios in the PLV group were smaller than those in the ALI group. The excellent alveolar recruitment suggests that liquid ventilation not only improves gas exchange but also ameliorates ventilator-associated lung injury.These results have been reported at the annual meetings of Japan Surgical Society (2002), Japanese Association for Thoracic Society (2001) and were published in Microcirculation Annual (2002) and Surgery (2003). Less