Abstract
Perfluorocarbons are structurally similar to hydrocarbons with the hydrogen replaced by fluorine. The carbon chains vary in length and an additional moiety often is attached to the molecule which, together, give unique properties to each perfluorocarbon. In general, perfluorocarbons have excellent oxygen and carbon dioxide carrying capacity (50 mL O2/dL and 160–210 mL C02/dL, respectively) [1]. They are clear, odorless, inert fluids which are immiscible in aqueous and most other solutions. They are relatively dense (1.7–1.9 g/mL),have a low surface tension (15–19 dynes/cm), and are relatively volatile with vapor pressures which range from 11 to 85 torr at 37°C. The vapor pressure of the individual perfluorocarbon governs the rapidity with which it evaporates from the lungs after intratracheal administration. As is demonstrated in fig. 1, perflubron (LiquiVent®, Alliance pharmaceutical Corp., san Diego, CA), which is currently the perflourocarbon most commonly used in clinical studies, is radiopaque, although this is not a characteristic of all of these fluids.
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References
Shaffer TH, Wolfson MR, Clark L, Jr (1992) Liquid ventilation. Pediatr Pulmonol 14: 102 – 109
Clark LC Jr, Gollan F (1966) Survival of mammals breathing organic liquids equilibrated with oxygen at atmospheric pressure. Science 152: 1755 – 1756
Shaffer TH, Moskowitz GD (1974) Demand–controlled liquid ventilation of the lungs. J Appi Physiol 36: 208 – 213
Greenspan JS, Wolfson MR, Rubenstein SD, Shaffer TH (1989) Liquid ventilation of preterm baby. Lancet 2: 1095
Greenspan JS, Wolfson MR, Rubenstein SD, Shaffer TH (1990) Liquid ventilation of human preterm neonates. J Pediatr 117: 106 – 111
Hirschl RB, Merz S, Montoya P, et al (1995) Development of a simplified liquid ventilator. Crit Care Med 23: 157 – 163
Fuhrman BP, Paczan PR, DeFrancisis M (1991) Perfluorocarbon–associated gas exchange. Crit Care Med 19: 712 – 722
Leach CL, Fuhrman BP, Morin Fd, Rath MG (1993) Perfluorocarbon–associated gas exchange (partial liquid ventilation) in respiratory distress syndrome: A prospective, randomized, controlled study. Crit Care Med 21: 1270 – 1278
Overbeck MC, Pranikoff T, Yadao CM, Hirschl RB (1996) The efficacy of perfluorocarbon liquid ventilation in a large animal model of acute respiratory failure. Crit Care Med 24: 1208 – 1214
Hirschl RB, Tooley R, Parent AC, et al (1995) Improvement of gas exchange, pulmonary function, and lung injury with partial liquid ventilation. A study model in a setting of severe res¬piratory failure. Chest 108: 500 – 508
Hernán LJ, Fuhrman BP, Kaiser R, et al (1995) Perfluorocarbon associated gas exchange in normal and acid–injured–large sheep. Crit Care Med 23 (Suppl): A264 (Abst)
Nesti FD, Fuhrman BP, Papo MC, et al (1994) Perfluorocarbon–associated gas exchange in gastric aspiration. Crit Care Med 22: 1445 – 1452
Tutuncu AS, Faithfull NS, Lachmann B (1993) Intratracheal perfluorocarbon administration combined with mechanical ventilation in experimental respiratory distress syndrome: Dose–dependent improvement of gas exchange. Crit Care Med 21: 962 – 969
Tooley R, Hirschl RB, Parent A, Bartlett RH (1996) Total liquid ventilation with perfluorocar–bons increases pulmonary end–expiratory volume and compliance in the setting of lung atelectasis. Crit Care Med 24: 268 – 273
Gattinoni L, D’Andrea L, Pelosi P, et al (1993) Regional effects and mechanism of positive end–expiratory pressure in early adult respiratory distress syndrome. JAMA 269: 2122 – 2127
Hirschl RB, Overbeck MC, Parent A, et al (1994) Liquid ventilation provides uniform distribution of perfluorocarbon in the setting of respiratory failure. Surgery 116: 159 – 167
Quintel M, R.B. H, Roth H, et al (1995) Assessment of perfluorocarbon (PFC) distribution during partial liquid ventilation (PLV) in the setting of acute respiratory failure. Am J Respir Crit Care Med 151: A446 (Abst)
Gauger PG, Overbeck MC, Chamber SD, et al (1995) Perfluorocarbon partial liquid ventilation improves gas exchange while augmenting decreased functional residual capacity in an animal model of acute lung injury. Surgery Forum 46: 669 – 671
Gauger PG, Overbeck MC, Koeppe RA, et al (1997) Distribution of pulmonary blood flow and total lung water during partial liquid ventilation in acute lung injury. Surgery (In press)
Quintel M, Heine M, Hirschl RB, et al (1997) Effects of partial liquid ventilation (PLV) on lung injury in a model of acute respiratory failure a histologic and morphometric analysis. Crit Care Med (In press)
Colton DM, Hirschl RB, Till GO, et al (1997) Neutrophil accumulation is reduced during partial liquid ventilation. Crit Care Med (In press)
Colton DM, Hirschl RB, Till GO, et al (1995) Lung vascular permeability is reduced during partial liquid ventilation (PLV) in the setting of respiratory failure. Am J Respir Crit Care Medl51: A446 (Abst)
Smith T, Steinhorn D, Marcucci K, et al (1994) Perflubron (PFB) decreases free radical (FR) production by alveolar macrophages (A–) in vitro. Crit Care Med 22: A196 (Abst)
Virmani R, Fink LM, Gunter K, English D (1984) Effect of perfluorochemical blood substitutes on human neutrophil function. Tranfusion 24: 343 – 347
Varani, Hirschl RB, Dame M, Johnson K (1996) Perfluorocarbon protects lung epithelial cells from neutrophil–mediated injury in an in vitro model of liquid ventilation therapy. Shock 6: 339 – 344
Wilcox DT, Glick PL, Karamanoukian HL, et al (1995) Perfluorocarbon–associated gas exchange improves pulmonary mechanics, oxygenation, ventilation, and allows nitric oxide delivery in the hypoplastic lung congenital diaphragmatic hernia lamb model. Crit Care Med 23: 1858 – 1863
Hirschl RB, Pranikoff P, Wise C, et al (1996) Initial experience with partial liquid ventilation in adult patients with the acute respiratory distress syndrome. JAMA 275: 383 – 389
Leach CL, Greenspan JS, Rubenstein SD, et al (1996) Partial liquid ventilation with perflubron in premature infants with severe respiratory distress syndrome. N Engl J Med 335: 761 – 767
Hirschl RB, Pranikoff T, Gauger P, et al (1995) Liquid ventilation in adults, children, and full–term neonates: Preliminary report. Lancet 346: 1201 – 1202
Pranikoff T, Gauger P, Hirschl RB (1996) Partial liquid ventilation in newborn patients with congenital diaphragmatic hernia. J Ped Surg 31: 613 – 618
Gauger PG, Pranikoff T, Schreiner RJ, Hirschl RB (1996) Initial experience with partial liquid ventilation in pediatric patients with the acute respiratory distress syndrome. Crit Care Med 24: 16 – 22
Kazerooni EA, Pranikoff T, Cascade PN, Hirschl RB (1996) Perfluorocarbon partial liquid ventilation during extracorporeal life support in adults: radiographic appearance. Radiolo¬gy 198: 137 – 142
Toro–Figueroa LO, Melinoes JN, Curtis SE, et al (1996) Perflubron partial liquid ventilation (PLV) in children with ARDS: A safety and efficacy pilot study. Crit Care Med 24: A150 (Abst)
Hirschl RB (1997) Pulmonary function during liquid ventilation. In: Donn S (ed) Neonatal and pediatric pulmonary graphic analysis: Principles and clinical applications. Futura, Mount Kisco, NY (In press)
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Hirschl, R.B. (1998). Experience in Liquid Ventilation. In: Marini, J.J., Evans, T.W. (eds) Acute Lung Injury. Update in Intensive Care and Emergency Medicine, vol 30. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60733-2_20
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DOI: https://doi.org/10.1007/978-3-642-60733-2_20
Publisher Name: Springer, Berlin, Heidelberg
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