• Alexandre T Rotta, Mário Eduardo G Viana, Budi Wiryawan, Guilherme A Sargentelli, Mark S Dowhy, Walter A Zin, and Bradley P Fuhrman.
• Department of Anesthesiology, University of Texas Medical Branch at Galveston, Pediatric Critical Care, Driscoll Children's Hospital, Corpus Christi, TX, USA.
• Pediatr Crit Care Me. 2006 Nov 1; 7 (6): 562-70.

ObjectiveTo evaluate the independent and combined effects of high-frequency oscillatory ventilation (HFOV) and partial liquid ventilation (PLV) on gas exchange, pulmonary histopathology, inflammation, and oxidative tissue damage in an animal model of acute lung injury.DesignProspective, randomized animal study.SettingResearch laboratory of a health sciences university.SubjectsFifty New Zealand White rabbits.InterventionsJuvenile rabbits injured by lipopolysaccharide infusion and saline lung lavage were assigned to conventional ventilation (CMV), PLV, HFOV, or high-frequency partial liquid ventilation (HF-PLV) with a full or half dose (HF-PLV1/2) of perfluorochemical (PFC). Uninjured ventilated animals served as controls. Arterial blood gases were obtained every 30 mins during the 4-hr study. Histopathologic evaluation was performed using a lung injury scoring system. Oxidative lung injury was assessed by measuring malondialdehyde and 4-hydroxynonenal in lung homogenates.Measurements And Main ResultsHFOV, PLV, or a combination of both methods (HF-PLV) resulted in significantly improved oxygenation, more favorable lung histopathology, reduced neutrophil infiltration, and attenuated oxidative damage compared with CMV. HF-PLV with a full PFC dose did not provide any additional benefit compared with HFOV alone. HF-PLV1/2 was associated with decreased pulmonary leukostasis compared with HF-PLV.ConclusionsThe combination of HFOV and PLV (HF-PLV) does not provide any additional benefit compared with HFOV or PLV alone in a combined model of lung injury when lung recruitment and volume optimization can be achieved. The use of a lower PFC dose (HF-PLV1/2) is associated with decreased pulmonary leukostasis compared with HF-PLV and deserves further study.

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