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J Thorac Cardiovasc Surg 1998;115:528-535
© 1998 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

Liquid Ventilation Improves Pulmonary Function And Cardiac Output In A Neonatal Swine Model Of Cardiopulmonary Bypass

Supported in part by a grant from the Duke Children's Hospital Miracle Network Telethon. LiquiVent was supplied by Alliance Pharmaceutical Corp. (San Diego, Calif.) and Hoechst Marion Roussel (Bridgewater, N.J.).

Read at the Seventy-seventh Annual Meeting of The American Association for Thoracic Surgery, Washington, D.C., May 4-7, 1997.

Received for publication May 5, 1997; revisions requested June 30, 1997; revisions received Oct. 23, 1997; accepted for publication Oct. 29, 1997. Address for reprints: Ira M. Cheifetz, MD, Duke University Medical Center, Box 3046, Durham, NC 27710.

Objective: Neonatal and infant cardiopulmonary bypass results in multiorgan system dysfunction. Organ protective strategies have traditionally been directed at the myocardium and brain while neglecting the sometimes severe injury to the lungs. We hypothesized that liquid ventilation would improve pulmonary function and cardiac output in neonates after cardiopulmonary bypass.
Methods: Twenty neonatal swine were randomized to receive cardiopulmonary bypass with or without liquid ventilation. In the liquid-ventilated group, a single dose of perflubron was administered before bypass. The control group was conventionally ventilated. Each animal was placed on nonpulsatile, hypothermic bypass. Low-flow cardiopulmonary bypass was performed for 60 minutes. The flow rate was returned to 125 ml/kg per minute, and after warming to 37° C, the animals were removed from bypass. Hemodynamic and ventilatory data were obtained after bypass to assess the effects of liquid ventilation.
Results: Without liquid ventilation, cardiopulmonary bypass resulted in a significant decrease in cardiac output, oxygen delivery, and static pulmonary compliance compared with prebypass values. Input pulmonary resistance and characteristic impedance increased in these control animals. At 30, 60, and 90 minutes after bypass, the animals receiving liquid ventilation showed significantly increased cardiac output and static compliance and significantly decreased input pulmonary resistance and characteristic impedance compared with control animals not receiving liquid ventilation.
Conclusions: Liquid ventilation improved pulmonary function after neonatal cardiopulmonary bypass while increasing cardiac output. The morbidity associated with cardiopulmonary bypass may be significantly reduced if the adverse pulmonary sequelae of bypass can be diminished. Liquid ventilation may become an important technique to protect the lungs from the deleterious effects of cardiopulmonary bypass.

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				L. Jiang, Q. Wang, Y. Liu, M. Du, X. Shen, X. Guo, and S. Wu Total liquid ventilation reduces lung injury in piglets after cardiopulmonary bypass. Ann. Thorac. Surg., July 1, 2006; 82(1): 124 - 130. [Abstract] [Full Text] [PDF]