Liquid ventilation

Q: Which liquid is used in Liquid Ventilation?

Answer: Liquid ventilation is accomplished through perfluorocarbon (PFC) liquid. Perflubron has several unique characteristics that make it very efficient in ventilation and oxygenation.

1. Perflubron is an excellent medium to carry respiratory gases. PFC at one pressure atmosphere can carry 20 times as much oxygen as saline.
2. It can be used as a surfactant product in premature infants or patients with ARDS or lung injury. The lung surface tension in an ARDS patient is 67 to 75 dynes/cm. In a lung with perflubron, the surface tension is only 18 dynes/cm, which helps prevent alveolar collapse and reduces alveolar opening pressures.
3. It will spread uniformly and quickly throughout the lungs to treat ARDS or as a surfactant.
4. PFCs are almost twice as dense as water. It will tend to circulate in dependent areas and those areas where gas exchange is most diminished. This characteristic is useful in the resolution of pulmonary edema.
5. The components of PFCs are not taken up by the body but evaporated by the lungs. Continuous administration may be necessary to maintain an adequate dosage. This is allowable because it does not break down into toxic metabolites like high gaseous oxygen concentrations.

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References;

1. Sarkar S, Paswan A, Prakas S. Liquid ventilation. Anesth Essays Res. 2014 Sep-Dec;8(3):277-82. doi: 10.4103/0259-1162.143109. PMID: 25886321; PMCID: PMC4258983.

2. Quintel M, Waschke KF, Meinhardt J. Flüssigkeitsventilation mit Perfluorcarbonen [Liquid ventilation with perfluorocarbons]. Anasthesiol Intensivmed Notfallmed Schmerzther. 1996 Oct;31(8):461-9. German. doi: 10.1055/s-2007-995960. PMID: 9019174.