0
Editorials |

Perfluorocarbon Fluid as a Mediator of Pulmonary Barotrauma : A Potential Hazard of Liquid Ventilation

Bob Demers, BS, RRT
Author and Funding Information

Carmel, CA


Correspondence to: Bob Demers, BS, RRT, Demers Consulting Services, 225 Crossroads Blvd, Suite 415, Carmel, CA 93923



Chest. 2000;117(1):8-10. doi:10.1378/chest.117.1.8
Text Size: A A A
Published online

Extract

In this issue of CHEST (see page 191), Ferreyra et al report their findings using partial liquid ventilation (PLV) in an animal model. This is a cutting-edge technology, and the article makes for fascinating reading. The perfluorocarbon fluid used in this technique is hyperdense, having a specific gravity of 1.92. This attribute poses a potential hazard for human patients, owing to the elevated hydrostatic pressure that this extremely dense liquid is able to exert.

Consider a case wherein PLV might be employed for an adult patient in the erect posture. In order to illustrate the pattern of distribution of the instillate, we are going to employ the modified roentgenogram shown in Figure 1. This posteroanterior chest radiograph was obtained in preparation for a CT scan, for which horizontal lines are automatically scribed onto the radiograph at 1-cm intervals. As perfluorocarbon fluid is instilled into the airway, it will percolate into the most dependent regions of the lung. Ferreyra et al continued to instill perfluorocarbon into the endotracheal tube until it reached the level of the teeth of the (animal) subject. If this methodology were duplicated in an erect human subject, the pattern of perfluorocarbon distribution would resemble that shown in Figure 2. We have overdrawn a line at each of the centimeter markers, beginning at the lateral costophrenic sulcus, upward to the level of the main stem bronchi. This vertical distance is observed, in this case, to be 8 cm. The posterior sulcus lies below this level, but we have chosen the lateral sulcus as our zero point because it is easier to visualize on the chest radiograph. Perfluorocarbon would rise to the 8-cm level within the lungs, at which point additional fluid would rise within the endotracheal tube. This additional instillate would be prevented from entering the portion of each lung overlying the 8-cm scribe line because the newly loculated gas lying above each hilum would have no route of egress.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543