Total Liquid Ventilation Reduces Lung Injury in Piglets After Cardiopulmonary Bypass

Background Cardiopulmonary bypass may cause lung injury that does not respond to traditional therapies. Total liquid ventilation has been developed as an alternative ventilatory strategy for severe lung injury. The aim of this study is to investigate the effect of total liquid ventilation on lung injury in piglets after cardiopulmonary bypass. Methods After exposure to 60 minutes of cardiac arrest and weaning from cardiopulmonary bypass, 12 piglets (4.2 ± 0.3 kg) were randomly treated with conventional gas ventilation (control group) or total liquid ventilation (study group) for 240 minutes. Samples for blood gas analysis were collected before, and at 30-minute intervals after, cardiopulmonary bypass. The degree of lung injury was quantified by histologic examination. The inflammatory cells and the levels of interleukin-6, interleukin-8, and myeloperoxidase in bronchoalveolar lavage were analyzed. Results Neutrophil and macrophage count in bronchoalveolar lavage were significantly decreased in the study group (52.4 ± 6.82 vs 0.46 ± 0.11 104/mL; 58.33 ± 0.88 vs 4.37 ± 0.90 105/mL; p < 0.001, respectively). The inflammation score and the total lung injury score were also reduced in the study group (4.39 ± 1.14 vs 2.61 ± 1.09; 11.06 ± 1.66 vs 6.94 ± 1.43; p < 0.05, respectively). The concentrations of interleukin-6 and myeloperoxidase in bronchoalveolar lavage were significantly reduced in the study group (81.32 ± 15.23 vs 53.55 ± 15.48 pg/mL, 75.00 ± 9.19 vs 50.00 ± 7.37 u/mL; p < 0.05, respectively), whereas the interleukin-8 levels were similar between both groups (551.63 ± 119.34 vs 563.68 ± 137.14 pg/mL, p > 0.05). Conclusions Total liquid ventilation with FC-77 (3M, St. Paul, MN) reduces biochemical and histologic lung injury in piglets after cardiopulmonary bypass.