Comparison of aerosol therapy with different perfluorocarbons in surfactant-depleted animals

OBJECTIVE:The study investigates the effectiveness of aerosol treatment on gas exchange and pulmonary inflammatory reaction using perfluorocarbons with different molecular structure and vapor pressure. DESIGN:Experimental, prospective, randomized, controlled study. SETTING:Experimental laboratory at a university hospital. SUBJECTS:Twenty anesthetized neonatal piglets assigned to four groups. INTERVENTIONS:After establishment of lung injury by bronchoalveolar lavage, piglets either received aerosolized FC77 (n = 5), perfluorooctylbromide (n = 5), or FC43 (n = 5, 10 mL·kg·hr1 for 2 hrs) or intermittent mandatory ventilation (control, n = 5). Thereafter, animals were supported for another 6 hrs. MEASUREMENTS AND MAIN RESULTS:PaO2 significantly improved in the perfluorocarbon groups compared with control (p < .01). Final PaO2 (mean ± sem) was FC77, 406 ± 27 mm Hg; perfluorooctylbromide, 332 ± 32 mm Hg; FC43, 406 ± 19 mm Hg; control, 68 ± 8 mm Hg. PaCO2 and mean pulmonary arterial pressure were lower in all perfluorocarbon groups compared with control. The ratio of terminal dynamic compliance to total compliance was significantly higher in the FC77 than in the FC43, perfluorooctylbromide, and control groups. Relative gene expression of interleukin-1β, interleukin-8, P-selectin, E-selectin, and intercellular adhesion molecule-1 in lung tissue was determined by TaqMan real time polymerase chain reaction normalized to hypoxanthine-guanine-phosphoribosyl-transferase and was shown to be reduced by all perfluorocarbons. CONCLUSIONS:Aerosol treatment with all the perfluorocarbons investigated improved gas exchange and reduced pulmonary inflammatory reaction independently from molecular structure and vapor pressure of the perfluorocarbons. Although differences in vapor pressure and molecular structure may account for varying optimal dosing strategies, several different perfluorocarbons were shown to be principally suitable for aerosol treatment.