Use of liquid ventilation with perflubron during extracorporeal membrane oxygenation: chest radiographic appearances.

Abstract

To assess the effectiveness of performing liquid ventilation with perflubron in neonates with severe respiratory failure or pulmonary hypertension who receive extracorporeal membrane oxygenation (ECMO) life support. We studied an infant (aged 1 month) and a neonate with respiratory failure who underwent ECMO and liquid ventilation with perflubron, which was slowly instilled via an endotracheal tube (in the infant, 40 mL for more than 1 hour; in the neonate, 28 mL within 1 hour). The infant survived termination of ECMO support and has been breathing room air since 6 months of age. The neonate died soon after ECMO support was withdrawn. A minority of neonates or infants with severe respiratory failure or pulmonary hypertension do not respond adequately to treatment with ECMO and are almost certain to die with termination of ECMO support. Liquid ventilation with perflubron offers a potential salvage therapy in this patient population. In addition, perflubron is a good contrast agent to use in the evaluation of neonatal pulmonary abnormalities.