Randomised comparison of partial liquid ventilation, nebulised perfluorocarbon, porcine surfactant, artificial surfactant, and combined treatments on oxygenation, lung mechanics, and survival in rabbits after saline lung lavage.

Abstract

To compare gas exchange, lung mechanics, and survival to 12 h in surfactant-depleted lung-injured rabbits, treated with partial liquid ventilation (PLV) with perfluorocarbon, nebulised perfluorocarbon, and porcine or artificial surfactant. Prospective randomised controlled study. Animal laboratory, University of Edinburgh, UK. Eighty-two adult female New Zealand white rabbits with surfactant deficiency and acute lung injury induced by repeated saline lavage. Animals were randomised to one of seven treatments: (a) control (n = 20); (b) PLV with perfluorocarbon PF 5080 (n = 12); (c) nebulised PF 5080 (n = 10); (d) artificial surfactant (n = 10); (e) porcine surfactant (n = 10); (f) artificial surfactant+PLV (n = 10); (g) porcine surfactant+PLV (n = 10). Arterial blood gases and dynamic compliance (Cdyn) were measured hourly until 12 h. Oxygenation was improved by PLV, porcine surfactant, porcine surfactant+PLV and artificial surfactant+PLV. Cdyn improved after treatment with PLV, porcine surfactant and PLV+porcine surfactant. Survival was greater with PLV and artificial surfactant+PLV. Neither nebulised PF 5080 nor artificial surfactant had a detectable effect. PLV, porcine surfactant and combinations of surfactant with PLV improved oxygenation, Cdyn and survival, but none was clearly superior to the others.