RESUMEN
ABSTRACT Liquid perfluorocarbon (PFC) instillation has been studied experimentally as an adjuvant therapy in the preservation of lung grafts during cold ischemia. The objective of this study was to evaluate whether vaporized PFC is also protective of lung grafts at different cold ischemia times. We performed histological analysis of and measured oxidative stress in the lungs of animals that received only preservation solution with low-potassium dextran (LPD) or vaporized PFC together with LPD. We conclude that vaporized PFC reduces the production of free radicals and the number of pulmonary structural changes resulting from cold ischemia.
RESUMO O perfluorocarbono (PFC) líquido tem sido estudado experimentalmente como uma substância adjuvante na preservação de enxertos pulmonares durante o período de isquemia fria. O objetivo deste estudo foi avaliar se o PFC vaporizado (e não instilado) também atuaria como protetor de enxertos pulmonares em diferentes tempos de isquemia fria. Realizamos análise histológica e dosamos o estresse oxidativo em pulmões de animais que receberam somente uma solução de preservação com low-potassium dextran (LPD, dextrana com baixa concentração de potássio) ou PFC vaporizado associado a LPD. Concluímos que o PFC vaporizado reduziu a produção de radicais livres e provocou menor número de alterações estruturais pulmonares decorrentes do período de isquemia fria que o uso de LPD isoladamente.
Asunto(s)
Humanos , Preservación de Órganos/métodos , Trasplante de Pulmón/métodos , Estrés Oxidativo/efectos de los fármacos , Isquemia Fría/métodos , Fluorocarburos/farmacología , Pulmón/efectos de los fármacos , Valores de Referencia , Factores de Tiempo , Reproducibilidad de los Resultados , Dextranos/farmacología , Soluciones Preservantes de Órganos , Glucosa/farmacología , Pulmón/patologíaRESUMEN
We sought to know whether there is a further improvement in gas exchange when partial liquid ventilation (PLV) is added to high-frequency oscillatory ventilation (HFOV) in a piglet model of saline lavage-induced acute lung injury. Seven 7-9 day-old newborn piglets of mixed strain were treated with repeated saline lavage to achieve a uniform degree of acute lung injury. Then, HFOV were applied to the subject. Four animals received two consecutive doses (15 mL/kg) of perfluorodecalin at 30-min interval (PFC+HFOV group). The other three animals remained on HFOV alone (HFOV-only group). Repetitive lung lavage led to a significant acute aggravation in both gas exchange and hemodynamic parameters. Subsequent application of HFOV produced a significant rapid recovery in both gas exchange and hemodynamic parameters to near baseline levels. During and after perfluorodecalin dosing, there were no significant changes in gas exchange or hemodynamic parameters over time in both groups, and no significant differences in gas exchange or hemodynamic parameters between groups. We concluded that the addition of 30 mL/kg of perfluorodecalin to HFOV showed no detrimental effect on hemodynamics, but did not produce a significant improvement in gas exchange over a three-hour period.
Asunto(s)
Animales , Animales Recién Nacidos , Presión Sanguínea , Fluorocarburos/farmacología , Concentración de Iones de Hidrógeno , Ventilación Liquida , Pulmón/lesiones , Oscilometría , Oxígeno/metabolismo , Intercambio Gaseoso Pulmonar , Insuficiencia Respiratoria , Cloruro de Sodio/farmacología , Porcinos , Factores de TiempoRESUMEN
The aim of this study was to determine the effect of partial liquid ventilation (PLV) using a perfluorocarbon (PFC) on gas exchange and lung inflammatory response in a canine acute lung injury model. After inducing severe lung injury by oleic acid infusion, beagle dogs were randomized to receive either gas ventilation only (control group, n = 6) or PLV (PLV group, n = 7) by sequential instillation of 10 mL/kg of perfluorodecalin (PFC) at 30 min intervals till functional residual capacity was attained. Measurements were made every 30 min till 210 min. Then the lungs were removed and bronchoalveolar lavage (BAL) (35 mL/kg) was performed on the right lung and the left lung was submitted for histologic analysis. There was significant improvement in PaO2 and PaCO2 in the PLV group compared to the control group (p < 0.05) which was associated with a significant decrease in shunt (p < 0.05). There was no significant difference in parameters of lung mechanics and hemodynamics. There was a significant decrease in cell count and neutrophil percentage in BAL fluid and significantly less inflammation and exudate scores in histology in the PLV group (p < 0.05). We conclude that PLV with perfluorodecalin improves gas exchange and decreases inflammatory response in the acutely-injured lung.
Asunto(s)
Perros , Femenino , Masculino , Animales , Recuento de Células Sanguíneas , Líquido del Lavado Bronquioalveolar , Dióxido de Carbono/análisis , Modelos Animales de Enfermedad , Fluorocarburos/farmacología , Hemodinámica , Histocitoquímica , Inflamación/prevención & control , Enfermedades Pulmonares/fisiopatología , Enfermedades Pulmonares/inducido químicamente , Ácido Oléico , Oxígeno/análisis , Intercambio Gaseoso Pulmonar/efectos de los fármacos , Ventilación Pulmonar/fisiología , Pruebas de Función Respiratoria , Ventiladores MecánicosRESUMEN
Os autores relatam sua experiência de 5 anos com o uso de perfluorocarbonos líquidos (perfluoropolieter, perfluorotribu-tilamina, perfluorooctano e perfluorodecalina) na cirurgia vitreo-retiniana. Como aplicaçöes, citam a possibilidade da eversäo de retalhos retinianos, manipulaçäo da retina, facilitaçäo na dissecçäo de membranas e para a vitrectomia periférica em caso de PVR anterior, reaplicaçäo da retina sem a necessidade de retinotomia posterior, e hemostasia em casos de sangramento difuso. Lembram, ainda, que devido à toxicidade retiniana os PFCL devem ser retirados da cavidade vítrea ao fim do ato operatório