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(Chest. 2001;119:1503-1509.)
© 2001 American College of Chest Physicians

Clinical Correlation With Changing Radiographic Appearance During Partial Liquid Ventilation*

Daniel P. Schuster, MD, FCCP; Neale R. Lange, MD; Ahmet Tutuncu, MD; Mark Wedel, MD and for the LiquiVent Study Group{dagger}

* From the Division of Pulmonary and Critical Care Medicine (Drs. Schuster and Lange), Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO; and Alliance Pharmaceutical Corporation (Drs. Tutuncu and Wedel), San Diego, CA. {dagger} A list of principal investigators is located in the Appendix.

Correspondence to: Daniel Schuster, MD, 660 S Euclid Ave, University Box 8225, St. Louis, MO 63110; e-mail: schusted{at}msnotes.wustl.edu

Study objectives: To evaluate the chest radiographic filling pattern associated with partial liquid ventilation (PLV) with the perfluorochemical perflubron (LiquiVent; Alliance Pharmaceutical Corp; San Diego CA) as a function of dose and timing.

Design: Post hoc review of chest radiographs by three independent observers with correlation to clinical variables.

Setting: Phase II randomized, uncontrolled, prospective, multicenter clinical trial.

Patients: Sixteen adult patients with diffuse bilateral infiltrates consistent with acute lung injury and a PaO2/fraction of inspired oxygen (FIO2) ratio < 300 with positive end-expiratory pressure of 13 cm H2O and FIO2 >= 0.5.

Interventions: All patients were treated with either a 10-mL/kg or 20-mL/kg loading dose of perflubron followed by maintenance dosing at 3-h intervals to protocol-determined levels.

Results: There was a significant relationship between inhomogeneous radiographic filling during the first 48 h of treatment and the use of the lower loading dose of perflubron. Inhomogeneous radiographic filling (in 5 patients) was associated with a lower high-dose/FIO2 ratio at 24 h compared with the remaining patients. These differences resolved by 48 h. There were no other statistically significant correlations identified.

Conclusions: The radiographic appearance of PLV with perflubron appears to depend on the dose administered. Lower doses can be associated with both inhomogeneous radiographic filling and a transient deterioration in oxygenation during the first 24 to 48 h of treatment.

Key Words: acute lung injury • ARDS • gas exchange






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