Skip to main content
Top
Published in: Intensive Care Medicine 8/2003

01-08-2003 | Experimental

Aerosolization of perfluorocarbons during mechanical ventilation: an in vitro study

Authors: Tobias Gregor, Gerd Schmalisch, Wolfram Burkhardt, Hans Proquitté, Roland R. Wauer, Mario Rüdiger

Published in: Intensive Care Medicine | Issue 8/2003

Login to get access

Abstract

Objective

Inhalation of perfluorocarbons (PFC) has been suggested as a new and promising technique of PFC delivery in animal models of severe lung injury. However, no in vitro data were available on the efficacy of PFC aerosolization during mechanical ventilation. Therefore, the aim of the in vitro study was to investigate the influence of physical properties of PFC and the ventilatory settings on the amount of PFC delivered into the lung.

Design

In vitro lung model study.

Setting

University research laboratory.

Measurements and results

Two different PFC (PF 5080 and PFOB) were aerosolized with a PariBoy jet nebulizer. Using a PFC selective adsorber, the effect of endotracheal tube size (2 mm and 3 mm diameter) on delivery of PFC was investigated. PFC delivery was estimated by continuous measurement of weight gain of the adsorber (adsorption rate). Finally, the influence of respiratory rate and tidal volume on adsorption rate (AR) was studied. AR was significantly reduced by a decreasing tube diameter and ranged from 1.45±0.03 ml/min (no tube) to 0.93±0.03 ml/min (2.0 mm) for PF 5080 (vapor pressure 51 mmHg) and from 0.49±0.06 ml/min to 0.32±0.04 ml/min for PFOB (11 mmHg). PFC-aerosolization into a ventilatory circuit with simulation of spontaneous tidal breathing (minute volume 600 ml) reduced AR to 0.16±0.02 ml/min. During mechanical ventilation, changes in respiratory rate and tidal volume, which reduce minute ventilation, caused a decrease in AR.

Conclusion

The amount of PFC that can be delivered into the lung by aerosolization is very small and is influenced by PFC properties, tube size, and ventilatory settings.
Literature
1.
go back to reference Bleyl JU, Ragaller M, Tschö U, Regner M, Kanzow M, Hübler M, Rasche S, Albrecht M (1999) Vaporized perfluorocarbon improves oxygenation and pulmonary function in an ovine model of acute respiratory distress syndrome. Anesthesiology 91:461–469PubMed Bleyl JU, Ragaller M, Tschö U, Regner M, Kanzow M, Hübler M, Rasche S, Albrecht M (1999) Vaporized perfluorocarbon improves oxygenation and pulmonary function in an ovine model of acute respiratory distress syndrome. Anesthesiology 91:461–469PubMed
2.
go back to reference Hübler M, Souders JE, Shade ED, Polissar NL, Bleyl JU, Hlastala MP (2002) Effects of perfluorohexane vapor on relative blood flow distribution in an animal model of surfactant-depleted lung injury. Crit Care Med 30:422–427PubMed Hübler M, Souders JE, Shade ED, Polissar NL, Bleyl JU, Hlastala MP (2002) Effects of perfluorohexane vapor on relative blood flow distribution in an animal model of surfactant-depleted lung injury. Crit Care Med 30:422–427PubMed
3.
go back to reference Kandler MA, von der Hardt K, Schoof E, Dötsch J, Rascher W (2001) Persistent improvement of gas exchange and lung mechanics by aerosolized perfluorocarbon. Am J Respir Crit Care Med 164:31–35PubMed Kandler MA, von der Hardt K, Schoof E, Dötsch J, Rascher W (2001) Persistent improvement of gas exchange and lung mechanics by aerosolized perfluorocarbon. Am J Respir Crit Care Med 164:31–35PubMed
4.
go back to reference Kelly KP, Stenson BJ, Drummond GB (2000) Randomised comparison of partial liquid ventilation, nebulised perfluorocarbon, porcine surfactant, artificial surfactant, and combined treatment on oxygenation, lung mechanics, and survival in rabbits after saline lung lavage. Intensive Care Med 26:1523–1530CrossRef Kelly KP, Stenson BJ, Drummond GB (2000) Randomised comparison of partial liquid ventilation, nebulised perfluorocarbon, porcine surfactant, artificial surfactant, and combined treatment on oxygenation, lung mechanics, and survival in rabbits after saline lung lavage. Intensive Care Med 26:1523–1530CrossRef
5.
go back to reference Duarte AG, Fink JB, Dhand R (2001) Inhalation therapy during mechanical ventilation. Respir Care Clin Am 7:233–260 Duarte AG, Fink JB, Dhand R (2001) Inhalation therapy during mechanical ventilation. Respir Care Clin Am 7:233–260
6.
go back to reference Rüdiger M, Köpke U, Prösch S, Rauprich M, Wauer RR, Herting E (2001) Effect of perfluorocarbons and perfluorcarbons/surfactant-emulsions on growth and viability of group B streptococci and Escherichia coli. Crit Care Med 29:1786–1791PubMed Rüdiger M, Köpke U, Prösch S, Rauprich M, Wauer RR, Herting E (2001) Effect of perfluorocarbons and perfluorcarbons/surfactant-emulsions on growth and viability of group B streptococci and Escherichia coli. Crit Care Med 29:1786–1791PubMed
7.
go back to reference Shaffer TH, Douglas PR, Lowe CA (1983) The effects of liquid ventilation on cardiopulmonary function in preterm lambs. Pediatr Res 17:303–303PubMed Shaffer TH, Douglas PR, Lowe CA (1983) The effects of liquid ventilation on cardiopulmonary function in preterm lambs. Pediatr Res 17:303–303PubMed
8.
go back to reference Meshko V, Markovska L, Mincheva M, Rodrigues AE (2001) Adsorption of basic dyes on granular activated carbon and natural zeolite. Water Res 35:3357–3366CrossRefPubMed Meshko V, Markovska L, Mincheva M, Rodrigues AE (2001) Adsorption of basic dyes on granular activated carbon and natural zeolite. Water Res 35:3357–3366CrossRefPubMed
9.
go back to reference Proquitté H, Rüdiger M, Jänchen J, Wauer RR (1999) Adsorption des PFC-verlustes bei liquid ventilation. Z Geburtshilfe Neonatol 203:32 [abstr] Proquitté H, Rüdiger M, Jänchen J, Wauer RR (1999) Adsorption des PFC-verlustes bei liquid ventilation. Z Geburtshilfe Neonatol 203:32 [abstr]
10.
go back to reference Roske K, Foitzik B, Wauer RR, Schmalisch G (1998) Accuracy of volume measurements in mechanically ventilated newborns: a comparative study of commercial devices. J Clin Monit Comput 14:413–420CrossRefPubMed Roske K, Foitzik B, Wauer RR, Schmalisch G (1998) Accuracy of volume measurements in mechanically ventilated newborns: a comparative study of commercial devices. J Clin Monit Comput 14:413–420CrossRefPubMed
11.
go back to reference Manczur T, Greenough A, Nicholson GP, Rafferty GF (2000) Resistance of pediatric and neonatal endotracheal tubes: influence of flow rate, size, and shape. Crit Care Med 28:1595–1598PubMed Manczur T, Greenough A, Nicholson GP, Rafferty GF (2000) Resistance of pediatric and neonatal endotracheal tubes: influence of flow rate, size, and shape. Crit Care Med 28:1595–1598PubMed
12.
go back to reference Schürch S, Amato M, Valls-i-Soler A (1999) Surface properties of surfactant perfluorocarbon combinations studied in a modified captive bubble system. Biol Neonate 76 [Suppl 1]:49 [abstr] Schürch S, Amato M, Valls-i-Soler A (1999) Surface properties of surfactant perfluorocarbon combinations studied in a modified captive bubble system. Biol Neonate 76 [Suppl 1]:49 [abstr]
13.
go back to reference Newman SP, Pellow PGD, Clarke SW (1987) Drop sizes from medical atomisers for drug solutions of different viscosities and surface tension. Atomisation Spray Tech 3:1–11 Newman SP, Pellow PGD, Clarke SW (1987) Drop sizes from medical atomisers for drug solutions of different viscosities and surface tension. Atomisation Spray Tech 3:1–11
14.
go back to reference Stalhofen W, Gebbert J, Heyder J (1980) Experimental determination of the regional deposition of aerosol particles in the human respiratory tract. Am Ind Hyg Assoc J 41:385–399PubMed Stalhofen W, Gebbert J, Heyder J (1980) Experimental determination of the regional deposition of aerosol particles in the human respiratory tract. Am Ind Hyg Assoc J 41:385–399PubMed
15.
go back to reference Fink JB, Dhand R, Duarte AG, Jenne JW, Tobin MJ (1996) Aerosol delivery from a metered-dose inhaler during mechanical ventilation. An in vitro model. Am J Respir Crit Care Med 154:382–387 Fink JB, Dhand R, Duarte AG, Jenne JW, Tobin MJ (1996) Aerosol delivery from a metered-dose inhaler during mechanical ventilation. An in vitro model. Am J Respir Crit Care Med 154:382–387
16.
go back to reference Fink JB, Dhand R, Grychowski J, Fahey PJ, Tobin MJ (1999) Reconciling in vitro and in vivo measurements of aerosol delivery from a metered-dose inhaler during mechanical ventilation and defining efficiency-enhancing factors. Am J Respir Crit Care Med 159:63–68 Fink JB, Dhand R, Grychowski J, Fahey PJ, Tobin MJ (1999) Reconciling in vitro and in vivo measurements of aerosol delivery from a metered-dose inhaler during mechanical ventilation and defining efficiency-enhancing factors. Am J Respir Crit Care Med 159:63–68
17.
go back to reference Harvey CJ, O'Doherty MJ, Page CJ, Thomas SHL, Nunan TO, Treacher DF (1995) Effect of a spacer on pulmonary aerosol deposition from a jet nebuliser during mechanical ventilation. Thorax 50:50–53PubMed Harvey CJ, O'Doherty MJ, Page CJ, Thomas SHL, Nunan TO, Treacher DF (1995) Effect of a spacer on pulmonary aerosol deposition from a jet nebuliser during mechanical ventilation. Thorax 50:50–53PubMed
18.
go back to reference Phipps PR, Gonda I (1994) Evaporation of aqueous aerosols produced by jet nebulisers: effects on particle size and concentration of solution in the droplets. J Aerosol Med 7:239–258PubMed Phipps PR, Gonda I (1994) Evaporation of aqueous aerosols produced by jet nebulisers: effects on particle size and concentration of solution in the droplets. J Aerosol Med 7:239–258PubMed
Metadata
Title
Aerosolization of perfluorocarbons during mechanical ventilation: an in vitro study
Authors
Tobias Gregor
Gerd Schmalisch
Wolfram Burkhardt
Hans Proquitté
Roland R. Wauer
Mario Rüdiger
Publication date
01-08-2003
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 8/2003
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-003-1733-z

Other articles of this Issue 8/2003

Intensive Care Medicine 8/2003 Go to the issue