Deatherage L, Biddle C
Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, USA.
AANA J. 1998 Apr;66(2):161-8.
The goal of mechanical ventilation is to maintain adequate gas exchange by opening and stabilizing alveolar units with minimal detriment to the pulmonary and circulatory systems. The optimal ventilatory strategy may be difficult to achieve, especially in patients with respiratory failure. Total liquid ventilation is a process whereby a liquid perfluorocarbon (PFC) replaces both the functional residual capacity and the tidal volume within the lung. Gas exchange is accomplished by mechanically assisted inspiration and expiration of tidal volumes of the liquid using a liquid ventilator. The PFC liquid is then oxygenated and purged of carbon dioxide by a membrane lung. Perfluorocarbons are excellent media for gas exchange due to their extraordinary gas solubility and diffusibility of oxygen and carbon dioxide. Partial liquid ventilation (PLV) is a modified method of the total liquid ventilation technique. In PLV, a functional residual capacity of PFC liquid is maintained in the lung, and the patient is ventilated with a conventional gas mechanical ventilator. Studies of the acute respiratory distress syndrome in animal models and in human series have demonstrated encouraging results using PLV and PFC. The high density, low surface tension, and other qualities of PFC in the setting of PLV may offer a highly innovative approach that can be directed toward the management of patients in respiratory failure.
机械通气的目标是通过打开并稳定肺泡单位来维持充分的气体交换，同时对肺和循环系统造成最小损害。最佳通气策略可能难以实现，尤其是在呼吸衰竭患者中。全液体通气是一个过程，通过该过程，液态全氟化碳（PFC）替代肺内的功能残气量和潮气量。气体交换通过使用液体通气机对液体潮气量进行机械辅助吸气和呼气来完成。然后，PFC液体通过膜肺进行氧合并排出二氧化碳。由于全氟化碳具有非凡的气体溶解度以及氧气和二氧化碳的扩散性，因此它是气体交换的理想介质。部分液体通气（PLV）是全液体通气技术的一种改良方法。在PLV中，肺内维持一定功能残气量的PFC液体，患者通过传统的气体机械通气机进行通气。在动物模型和人体系列中对急性呼吸窘迫综合征的研究表明，使用PLV和PFC可取得令人鼓舞的结果。在PLV环境下，PFC的高密度、低表面张力和其他特性可能提供一种极具创新性的方法，可用于治疗呼吸衰竭患者。
