Peep Sensitivity during Tidal Liquid Ventilation

Abstract 1927 Poster Session I, Saturday, 5/1 (poster 49)

During tidal liquid ventilation (TLV), replacement of the alveolar-gas interface with a liquid-liquid interface reduces surface tension, improves pulmonary compliance (C), supports lung volume recruitment and gas exchange at lower inflation pressures with reduced pulmonary injury as compared to conventional mechanical ventilation (CMV) (J Appl Physiol 72(3): 1024, 1992). Objective: To compare the effect of positive end expiratory pressure (PEEP) during TLV and CMV on central hemodynamics and oxygen delivery in preterm lambs (n = 14; 125 ±1SE dys gest.; 2.20±.18 kg). Methods: Following cesarean section, the lambs were instrumented with central venous, carotid and pulmonary arterial lines, intubated, delivered, and assigned to perfluorochemical (Hostinert 130; Hoechst Celanese) TLV or CMV (F₁O₂ = 1). Respiratory compliance (C), gas exchange, systemic and pulmonary vascular pressures, blood flow (echo/Doppler: aortic [AoQ], pulmonary [PaQ], ductal [L-R, R-L DQ], total pulmonary [tPBQ] measurements were performed at 3 levels of PEEP (cm H₂O: low [4], mid [8], high [12]). Systemic and pulmonary vascular resistances (SVR, PVR) and oxygen delivery (DO₂) were calculated. Results: Mean±SE; ANOVA with post hoc testing ; p < 0.05* vs PEEP; #CMV vs TLV. (Table) Conclusions: Compliance, aortic and pulmonary blood flow, and oxygenation were higher and pulmonary vascular resistance was lower during TLV than CMV, independent of PEEP level. Cardiopulmonary stability was achieved at lower PEEP during TLV than CMV.

Table 1 No caption available

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