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Liquid Ventilation

Liquid Ventilation. Chii-Yuh Kuo, MD, MPH 郭啟昱 醫師. Liquid ventilation. Eliminate air-fluid interface An alternative approach to gas breathing. Perfluorocarbon (PFC). Inert No odor No color Low surface tension Carry large amount of O 2 & CO 2. Liquid ventilation.

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Liquid Ventilation

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  1. Liquid Ventilation Chii-Yuh Kuo, MD, MPH 郭啟昱 醫師

  2. Liquid ventilation • Eliminate air-fluid interface • An alternative approach to gas breathing

  3. Perfluorocarbon (PFC) • Inert • No odor • No color • Low surface tension • Carry large amount of O2 & CO2

  4. Liquid ventilation • The first animal experiment - (Clark & Gollan et al, 1966) • The first human trial - (Greenspan et al, 1990)

  5. Liquid ventilation of human preterm neonates Greenspan SJ, et al. J Pediatr, 1990

  6. Medication: morphine sulfate (0.1mg/kg/dose), pavulon (0.1 mg/kg/dose), rimar (30 ml/kg) • Ventilation settings: Ti 5 sec, hold 10 sec, Te 5 sec (3-6 cycles/min), CO2 eleminated by increase tidal volume, O2 managed by change O2 content and FRC

  7. Conclusion • This satisfactory initial outcome shows the feasibility and potential of this treatment of pulmonary dysfunction in the preterm neonate

  8. Method of Liquid Ventilation • Total liquid ventilation (TLV) • Partial liquid ventilation (PLV)

  9. Total liquid ventilation

  10. Applications of TLV • RDS • ARDS • MAS • Pneumonia • Enhance lung growth

  11. Liquid Assisted Ventilation: An alternative ventilatory strategy for acute meconium aspiration injuryFoust Raymond, et al.Pediatr Pulmonol 1996

  12. Liquid ventilation for treatment of meconium aspration syndrome in a piglet model Kuo CY, et al. J Formos Med Assoc 1998

  13. Continuous Intraplmonary Distension with Perfluorocarbon Accelerates Neonatal (But Not Adult) Lung GrowthNobuhara KK, et al.J Pediatr Surgery, 1998

  14. Partial Liquid Ventilation

  15. Applications of Partial Liquid Ventilation • RDS • CDH • ARDS • Shock

  16. Partial liquid ventilation with perflubron in premature infants with severe respiratory distress syndrome Leach CL, et al. NEJM, 1998

  17. Partial liquid ventilation in newborn patients with congenital diaphragmatic hernia Pranikoff T, et al J Pediatr Surg, 1996

  18. Perfluocarbon LiquiVent (6  1 mL /kg/day/dose/day)

  19. Initial experience with partial liquid ventilation in pediatric patients with the acute respiratory distress syndrome Gauger PG, et al. Crit Care Med, 1996

  20. Perfluocarbon LiquiVent (12.9  2.3 mL/kg/dose/day)

  21. Intratracheal perfluorocarbon administration as an aid in the ventilatory management of respiratory distress syndrome Tutuncu SA, et al. Anesthesiology, 1993

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