Quintel M, Waschke K F, Meinhardt J
Institut für Anästhesiologie und Operative Intensivmedizin, Fakultät für Klinische Medizin Mannheim der Universität, Heidelberg.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1996 Oct;31(8):461-9. doi: 10.1055/s-2007-995960.
Clark and Gollan demonstrated impressively in 1966 the ability of perfluorchemicals (PFCs) to transport oxygen and to provide gas exchange across the alveolar capillary membrane. PFCs are used for two major medical indications: as artificial blood substitutes and as a medium for liquid ventilation. The PFC perflubron is additionally used as a contrast medium for diagnostic radiologic procedures. For the intravenous application perfluorocarbons have to be emulgated in phospholipids for the intrapulmonary application the sterile pure solution is used. Liquid ventilation can either be performed by a method known as total liquid ventilation (TLV), in which a device is utilised to ventilate with perfluorocarbon the previously perfluorocarbon-filled lung, or as partial liquid ventilation (PLV) in which a conventional mechanical gas ventilator is used to gas ventilate the partially perfluorocarbon-filled lung. A number of studies have demonstrated the efficacy of perfluorocarbon liquid ventilation in improving gas exchange and pulmonary function in a number of animal species in the setting of acute respiratory failure. In 1989 Greenspan reported on the first human liquid ventilation experience in a neonate. More recently human experiences for neonatal, paediatric and adult patients with acute lung injury have been reported. Since 1995 an FDA-approved study to examine the efficacy of PLV in severe respiratory failure in patients of all ages has been undertaken in the United States. The number of PLV-treated patients is still small; if PLV demonstrates its efficacy even in the ongoing human studies, it might be a very effective additional tool for treating severe acute lung injury.
1966年，克拉克和戈兰令人印象深刻地证明了全氟化合物（PFCs）运输氧气并在肺泡毛细血管膜上进行气体交换的能力。全氟化合物用于两个主要医学指征：作为人工血液替代品和作为液体通气的介质。全氟溴烷还用作诊断放射学程序的造影剂。对于静脉内应用，全氟碳必须在磷脂中乳化；对于肺内应用，则使用无菌纯溶液。液体通气可以通过一种称为全液体通气（TLV）的方法进行，即利用一种装置用全氟碳对先前充满全氟碳的肺进行通气，或者作为部分液体通气（PLV），其中使用传统的机械气体呼吸机对部分充满全氟碳的肺进行气体通气。多项研究表明，在急性呼吸衰竭的情况下，全氟碳液体通气在改善多种动物物种的气体交换和肺功能方面具有疗效。1989年，格林斯潘报告了首例新生儿液体通气的人体经验。最近，也有关于新生儿、儿科和成年急性肺损伤患者的人体经验报告。自1995年以来，美国开展了一项由美国食品药品监督管理局（FDA）批准的研究，以检验部分液体通气在各年龄段严重呼吸衰竭患者中的疗效。接受部分液体通气治疗的患者数量仍然很少；如果部分液体通气即使在正在进行的人体研究中也能证明其疗效，那么它可能会成为治疗严重急性肺损伤的一种非常有效的辅助工具。
