PEDIATRICS Vol. 99 No. 1 January 1997, pp. e2 (doi:10.1542/peds.99.1.e2)
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PEDIATRICS Vol. 99 No. 1 January 1997, p. e2
Copyright ©1997 by the American Academy of Pediatrics

ELECTRONIC ARTICLE:
Partial Liquid Ventilation in Critically Ill Infants Receiving Extracorporeal Life Support

Received Mar 18, 1996; accepted Jul 25, 1996.

Jay S. Greenspan*, William W. FoxDagger , S. David Rubenstein§, Marla R. Wolfson§, par , Susan S. Spinner*, Thomas H. Shaffer§, par , and Philadelphia Liquid Ventilation Consortium

From the * Department of Pediatrics, Jefferson Medical College, Thomas Jefferson University Hospital, Dagger  Department of Pediatrics, University of Pennsylvania School of Medicine, Children's Hospital of Philadelphia, and Departments of § Pediatrics and par  Physiology, Temple University School of Medicine, St Christopher's Hospital for Children, Philadelphia, Pennsylvania.

Objectives.  To demonstrate that a period of partial liquid ventilation (PLV) with perflubron improves pulmonary function, without adverse events, in a select group of critically ill infants receiving extracorporeal life support (ECLS) with a high likelihood of mortality.

Methods.  This was an open-label, noncontrolled, phase I and II trial of PLV in two infants with congenital diaphragmatic hernia and four infants with acute respiratory distress syndrome (ARDS) who were failing to improve while receiving ECLS. PLV was performed by instilling and maintaining a functional residual capacity of sterile perflubron for 4 to 96 hours.

Results.  Four infants were successfully weaned off ECLS for at least 3 days, and two infants (both with ARDS) are long-term survivors after PLV. All infants demonstrated lung recruitment and improved lung compliance, and there were no adverse events related to PLV.

Conclusions.  The study suggests that perflubron PLV is safe, improves lung function, and recruits lung volume in critically ill infants receiving ECLS. PLV therapy for infants with ARDS seems to have a great deal of promise. Based on this and other phase I and II trials, studies of PLV on selected full-term infants before ECLS have been initiated. congenital diaphragmatic hernia, acute respiratory distress syndrome, partial liquid ventilation, extracorporeal life support.


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