Partial liquid ventilation with perflubron during extracorporeal life support in adults: radiographic appearance

Abstract

Purpose: To describe the radiographic appearance of perflubron-filled lungs during partial liquid ventilation (PLV).

Materials and methods: Supine chest radiographs (391 anteroposterior, 154 lateral radiographs) were obtained before and after daily perflubron instillation in 13 adults undergoing PLV who were receiving extracorporeal life support. Perflubron distribution, barotrauma, and inability to discern catheters were evaluated.

Results: Immediately after instillation of perflubron, opacification of more than two-thirds of the lungs was shown in 12 of 13 patients. A gravity-dependent distribution of perflubron was shown on 146 (95%) of 154 lateral radiographs. Perflubron gradually cleared until it filled less than one-third of the lungs 6.8 days later (range, 2-20 days). In the five survivors, minimal perflubron was visible up to 138 days. In five patients, perflubron increased the visibility of small pneumothoraces present before PLV. Location of intrathoracic catheters was obscured on 44 radiographs.

Conclusion: Perflubron symmetrically opacifies the lungs in a gravity-dependent distribution during PLV and clears to minimal levels within 3 weeks.