Publikationsserver der RWTH Aachen University
Ventilations-Perfusions-Verteilungsstörungen während partieller Flüssigkeitsbeatmung mit semifluorierten Alkanen (SFA) bei experimentell induziertem Lungenversagen
Abstract
dc:descriptionExperimental studies on partial liquid ventilation (PLV) with Perfluorocarbons (PFC) in a model of the acute respiratory distress syndrome (ARDS) have shown good results concerning oxygenation and ventilation-perfusion distribution with a decrease of shunt. Unfortunately these positive results could not be confirmed in clinical studies, so that a therapy with PLV cannot be recommended for treatment of the ARDS at the moment. The PLV nevertheless still offers further therapeutic possibilities. With help of a liquid as a carrier drugs can be delivered directly to the pulmonary system. In studies a higher tissue level of the drug was found for the intratracheal administration compared with the intravenous administration of a drug with the same systemic level. Semifluorinated alkanes (SFA) have advantage over PFC by their structure. They are amphiphilic. So they are able to solve different drugs or a higher level than PFC, without losing the characteristics of the PFC (Oxygen-, carbon dioxide-solubility, physiologically inert, high density). The present study investigated whether PLV with SFA is possible with an experimentally induced lung failure in a large animal model. Aim parameters were ventilation-perfusion relationship, hemodynamics and gas exchange. Twenty-four pigs were prospectively randomized in two experimental groups after the induction of a lung failure. The first group (PLV) got an transtracheal administration of 7,5 ml/kg of the SFA once per hour with a cumulative dose of 30 ml/kg after 4 hours. The second group (CTRL) was respirated with standard parameters used in intensive care medicine. Overall, 21 data sets (PLV: 9, CTRL: 12) were evaluated. The ventilation-perfusion distribution was determined by the Multiple Inert Gas Elimination Technique (MIGET). The results suggested that the SFA were able to recruit atelectatic areas. Shunt areas participated in the gas exchange and were changed dose-dependently into Low VA/Q-areas. No parameter of gas exchange showed significant intra- and intergroup changes, during the entire measurement period. CVP and the PCWP increased significantly under the influence of the SFA and the associated weight during PLV. This observation is in line with earlier accomplished studies. The effect was however small. Taken together, the present results suggest that the PLV using SFA is possible with this model of lung damage without strong influence on hemodynamics and gas exchange. We could demonstrate that the SFA are able to recruit atelectatic areas. Shunt areas participated again in the gas exchange and were changed dose-dependently into Low VA/Q-areas. The MIGET investigation has shown that the SFA reach the damaged lung areas. They are able to open these areas, so that these can participate again in the gas exchange. Further investigations should follow now, to investigate whether drugs can be administrated by SFA transtracheally.
Degree
thesis:*- Grantor dc:publisher
- Publikationsserver der RWTH Aachen University
- Year dc:date
- 2010
Author and committee
dc:creator, dc:contributor.*- Author dc:creator
-
- Dalla Riva, Francesco
- Contributors dc:contributor
-
- Kuhlen, Ralf
Subjects
dc:subject × 6Rights
dc:rights- Statement dc:rights
-
- info:eu-repo/semantics/openAccess
- Language dc:language
- ger