Dose Of Perflubron Research Articles

Effect of continuous rotation on the efficacy of partial liquid (perflubron) breathing in canine acute lung injury.

Perfluorocarbons are liquids characterized by relatively low surface tension (10 to 20 dyne/cm) and high oxygen solubility (Clark, 1985). Liquid breathing can significantly improve gas exchange in animals with acute lung injury or surfactant deficiency (Calderwood et al., 1973; Shaffer et al., 1976, 1983a, 1983b, 1984). In several of the studies by Shaffer et al. (1976, 1983a, 1984), after drainage of most perfluorocarbon from the lung and conversion to gas breathing, improvements in arterial PO2 and lung mechanics persisted, suggesting that residual perfluorocarbon in the lung may have functioned as an artificial surfactant. The use of gas breathing combined with partial lung doses of perfluorocarbon has recently received increased attention, with positive results seen both in animal models of restrictive lung disease and in premature human infants (Curtis et al., 1993a; Greenspan et al., 1990; Richman et al., 1993; Tiitiincii et al., 1993). We previously tested the effects of sequential doses of perflubron (LiquiVent’’, Alliance Pharmaceutical Inc.) from one-sixth of FRC up to full FRC in dogs with severe oleic acid induced lung injury (Curtis et al., 1993b). Moderate improvements in PaO2 occurred after 50% lung filling, with the largest increases in PaO2 seen after complete lung filling. We speculated that, similar to the situation seen with bolus surfactant administration (Lewis et al., 1993), perflubron may not be homogeneously distributed in acutely injured lungs. The high density of perflubron (1.9 g/ml) would also favor a selectively dependent distribution. This study tested the hypothesis that continuous physical rotation of the subject would improve distribution of perflubron within the lungs, and produce greater improvements of PaO2 and compliance at smaller perflubron doses. To achieve this rotation, a mechanical bed commonly used in intensive care settings (to prevent the complications of immobility (Choi, 1992)) was employed. Rotated, oleic-acid injured dogs did (R/PFB) or did not (R/CON) receive serial doses of perflubron and were compared to our two previously studied non-rotated groups (NR/CON and NR/PFB).KeywordsOleic AcidAcute Lung InjuryContinuous RotationLiquid VentilationSerial DoseThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Partial liquid breathing with perflubron improves arterial oxygenation in acute canine lung injury.

Tidal liquid breathing with perfluorocarbon liquid improves lung mechanics and gas exchange in surfactant-deficient lambs. We asked whether an intratracheal dose of perflubron equal to liquid functional residual capacity (FRC) or less (partial liquid breathing) would alter gas exchange in gas-ventilated, anesthetized, and oleic acid (OA)-injured dogs. We gave eight dogs perflubron in six aliquots, each equal to one-sixth of liquid FRC [sequential dose (SEQ) group], starting 90 min after OA. Two other groups of eight dogs each received a liquid FRC dose of perflubron (60-70 ml/kg) either just before (P-Pre) or 90 min after (P-Post) OA, and eight control (CON) dogs received OA but no perflubron. In CON, SEQ, and P-Post dogs, OA caused a significant decrease in static respiratory system compliance (Crs) (1.50 +/- 0.05 to 1.15 +/- 0.06 ml.cmH2O-1.kg-1) and arterial PO2 (508 +/- 10 to 113 +/- 16 Torr) by minute 90. In P-Pre, P-Post, and after the third dose of perflubron (50% FRC) in SEQ dogs, arterial PO2 was significantly higher than that in the CON dogs but was similar to that in the CON dogs after perflubron removal. Perflubron doses less than two-thirds of liquid FRC were associated with increased Crs compared with CON dogs, but further lung filling caused a decrease in Crs. Lung histology showed widespread edema and hemorrhage and was similar in perflubron and CON dogs. O2 delivery and uptake were well maintained in all four groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Perfluorooctylbromide as a contrast agent for CT and sonography: preliminary clinical results.

Perflubron emulsion is a bromine-based particulate contrast agent that is taken up selectively by the liver and spleen after IV injection. It does not leave the vascular space and also persists in the blood for a longer period than iodinated contrast agents do. We performed a preliminary study to determine the value of the IV perflubron emulsion as a contrast material for CT and sonography. To determine the safety and dose response of perflubron emulsion as an IV contrast agent for CT and sonography, 18 cancer patients, 14 of whom had hepatic metastases, were given 0.5-3.0 ml/kg of the emulsion. Sonography and CT of the liver and spleen were performed before and immediately after infusion and then again at 24 hr. A persistent increase in the density of blood, liver, and spleen was observed, where maximal enhancements of 55, 39, and 317 H, respectively, were achieved. Tumor conspicuity increased as metastases enhanced minimally (7 H or less). Peak enhancement of the liver and spleen was delayed to 24 hr with higher doses of perflubron; however, the immediate postinfusion scan allowed the distinction of vessels from hepatic lesions. Sonographically, an increase in tumor echogenicity relative to liver was observed in nine of the 14 subjects, allowing the detection of additional metastases in two. Splenic echogenicity in the near field increased relative to kidney; however, attenuation increased markedly at the time of peak concentration, limiting beam penetration. Similar but milder changes were observed in the liver. Adverse effects occurred in 14 of the subjects; these included lower back pain in six, delayed fever in eight, and malaise in three. Perflubron emulsion produced prolonged enhancement of blood, liver, and spleen and increased the conspicuity of liver metastases. However, the side effects encountered could limit its use to a selected population of patients.