To: UnderCover who wrote (5396 ) 5/16/2005 2:19:47 PM From: UnderCover Read Replies (1) | Respond to of 5402 Liquid Ventilation There are two modes of liquid ventilation. Partial Liquid ventilation, (PLV - also known as perfluorocarbon assisted gas exchange or PAGE). Liquid is added to the lungs up to the Functional residual capacity (FRC - the total volume of the lung minus the normal breathing volume) and breathing is performed normally with gas ventilation. Tidal Liquid Ventilation, (TLV, also known as total liquid ventilation) in which the lung is filled at each breath with oxygenated perfluorocarbon. This requires very precise volumes of liquid to be administered at each breath. Liquid ventilation with perfluorocarbons has a number of potential benefits including: * Increased compliance (more flexibility in the lung material) * Reduced inflation pressure; as the liquid is not compressible is will evenly spread into the whole lung. This will reduce barotrauma (lung injury due to high pressure). * Removal of pulmonary debris. TLV washes away any foreign matter from the lungs. * Promotion of surfactant production * Anti-inflammatory effect Liquid ventilation has been used in conjunction with extra-corporeal membrane oxygenation (ECMO), whereby blood is taken from the body, oxygenated by a machine, and returned to the body. Liquid ventilation has been used in conjunction with ECMO for preterm babies suffering from a condition called cogenital diaphragmatic hernia, where the diaphragm between the upper body cavity and the lower isn't properly formed, allowing the internal organs to 'over flow' into the upper cavity, which is the space that the lungs use for inflation. Perfluorocarbon will gently inflate the lungs, pushing the distended organs into the lower cavity. Perfluorocarbons can also be used to clean debris out of lungs. Foreign matter tends to float on the dense liquid and is therefore readily removed. This has been demonstrated in the removal of charcoal and aspirated vomit. Typical Compound: Perfluorodecalin '(hopfully sangine looking into this ??)' TH Schaffer at al, Cells, Blood Subs, and Immob. Biotech, 1994, 22, 315-26 CA Cox et al Neonatal Netw. 1996 15 31-43 Liquid ventilation in Adults, Children and full-term neonates, Ronald B Hirschel, Thomas Pranikoff, Paul Guuager, Robert J Schreiner, Ronald Dechert, Robert H Bartlett