Wiryawan Budi, Dowhy Mark S, Fuhrman Bradley P, Rotta Alexandre T
Division of Pediatric Critical Care, The Women and Children's Hospital of Buffalo, State University of New York at Buffalo, NY, USA.
Pediatr Crit Care Med. 2005 Nov;6(6):690-7. doi: 10.1097/01.pcc.0000171156.17113.2d.
To evaluate the effect of low-bias flow oscillation (LBFO) with partial liquid ventilation (PLV) on perfluorochemical evaporation, histopathology, and oxidative tissue damage in an animal model of acute lung injury.
Prospective, randomized animal study.
Research laboratory of a health sciences university.
Twelve New Zealand White rabbits.
Juvenile rabbits were anesthetized, paralyzed, and ventilated through a tracheostomy with either high-frequency oscillatory ventilation or LBFO. Lung injury was induced by repeated saline lavage, after which perflubron was instilled through a side port of the endotracheal tube. Lateral fluoroscopic images were performed at baseline and at various postfill intervals of animals in the high-frequency oscillatory ventilation-PLV and LBFO-PLV groups. The images were digitalized for computer analysis of the Lung Lucency Index, a surrogate marker of perflubron evaporation. Histopathologic evaluation was performed using a lung-injury scoring system. Malondialdehyde was measured in lung homogenates to assess oxidative damage.
There were no significant differences in gas exchange and ventilator settings between groups throughout the experiment. At 300 mins, the high-frequency oscillatory ventilation-PLV group had a significantly higher Lung Lucency Index compared with the LBFO-PLV group in both dependent and nondependent lung regions (a high Lung Lucency Index correlates with increased perflubron loss). Malondialdehyde measurements were not different between groups. Animals treated with LBFO-PLV had a lower histopathologic lung-injury score compared with high-frequency oscillatory ventilation-PLV.
LBFO-PLV is a viable mode of ventilation in a model of acute lung injury and is associated with significant preservation of perflubron in comparison with high-frequency oscillatory ventilation-PLV. The lower evaporative losses during LBFO-PLV were associated with improved histology scores.
评估低偏流振荡（LBFO）联合部分液体通气（PLV）对急性肺损伤动物模型中全氟化合物蒸发、组织病理学及氧化组织损伤的影响。
前瞻性随机动物研究。
一所健康科学大学的研究实验室。
12只新西兰白兔。
幼年兔麻醉、麻痹后，通过气管切开术接受高频振荡通气或LBFO通气。通过反复盐水灌洗诱导肺损伤，之后通过气管内导管侧孔注入全氟溴烷。在高频振荡通气 - PLV组和LBFO - PLV组动物的基线及不同填充后时间点拍摄侧位荧光透视图像。图像数字化后用于计算机分析肺透明度指数，这是全氟溴烷蒸发的替代指标。使用肺损伤评分系统进行组织病理学评估。测量肺匀浆中的丙二醛以评估氧化损伤。
整个实验过程中，两组间气体交换和通气设置无显著差异。300分钟时，高频振荡通气 - PLV组在依赖肺区和非依赖肺区的肺透明度指数均显著高于LBFO - PLV组（高肺透明度指数与全氟溴烷损失增加相关）。两组间丙二醛测量值无差异。与高频振荡通气 - PLV组相比，LBFO - PLV组治疗的动物组织病理学肺损伤评分更低。
在急性肺损伤模型中，LBFO - PLV是一种可行的通气模式，与高频振荡通气 - PLV相比，能显著保留全氟溴烷。LBFO - PLV期间较低的蒸发损失与组织学评分改善相关。
