Effect of ventilation mode on gas exchange during partial liquid ventilation at different perfluorocarbon doses in surfactant-depleted lung

Abstract

Although gas ventilation is an integral part of partial liquid ventilation (PLV), the role of ventilation mode during PLV is not established, especially at a varying perfluorocarbon dose. In 10 surfactant-depleted rabbits, PLV was performed at a low dose (10 ml/kg) and at a functional residual capacity (FRC) dose (30 ml/kg) of perfluorodecalin in pressure-control (PC) and volume-control (VC) modes in balanced sequence. In these four PLV trials, PC mode was adjusted to be identical to VC mode with regard to tidal volume and inspiratory-to-expiratory ratio. PaO2 during PLV in PC mode was higher than in VC mode at the Low dose (159 plus minus 93 mm Hg, 115 plus minus 75 mm Hg, respectively: p = 0.005) and at the FRC dose (228 +/- 114 mm Hg, 164 +/- 104 mm Hg, respectively: p = 0.002). PaCO2 during PLV in PC mode was lower than in VC mode at the Low dose (59 +/- 18 mm Hg, 72 +/- 20 mm Hg, respectively: p = 0.005), whereas PaCO2 at the FRC dose was not different between modes. Curves of inspiratory flow appeared least deformed with PLV in PC mode at the Low dose, whereas they were saw-tooth deformed with PLV in VC mode at both doses. Actual time for inspiratory gas flow during PLV was shorter in PC mode compared with VC mode at both doses. In conclusion, in surfactant-depleted rabbit, gas exchange during PLV was better with PC mode compared with VC mode, especially at a low perfluorocarbon dose. Given the same tidal volume, PC appeared to insufflate the perfluorocarbon-filled lung better than VC at both low and FRC doses of perfluorocarbon.