![]() ![]() These repetitive tracheal collapses cause progressive accumulation and trapping of fluid in the lungs ( Costantino et al., 2004 Bagnoli et al., 2007). These advances have allowed for tighter control over the end-expiratory lung volume of PFC, mainly through prevention of tracheal collapse occurring when excessive negative pressure is applied during expiration. Over the past decade, our team has developed a liquid ventilator prototype that allows for precise control over pressures and flows delivered to the lungs ( Robert et al., 2010 Sage et al., 2018a, b). Perflubron, the PFC used for this study, also has anti-inflammatory properties that could reduce VILI ( Thomassen et al., 1997 Woods et al., 2000). In comparison to conventional gas ventilation, this was shown to ameliorate tidal-volume distribution and to require less positive pressure, thus reducing VILI in animal models ( Tooley et al., 1996 Wolfson et al., 2008 Avoine et al., 2011 Pohlmann et al., 2011 Sage et al., 2018b). Total liquid ventilation (TLV) uses liquid perfluorochemicals (PFCs), such as perflubron (PFOB, perfluorooctyl bromide), together with a dedicated liquid ventilator. Total liquid ventilation has been suggested as an alternative to conventional mechanical ventilation for various conditions affecting the neonate, such as children born with diaphragmatic hernia ( Snoek et al., 2014), meconium aspiration syndrome ( Avoine et al., 2011) or who are born extremely premature ( Shaffer et al., 1999 Davidson and Berkelhamer, 2017). In conclusion, we found no advantage of lower tidal volume use, which was in fact associated with a slightly unfavorable pattern of inflammatory gene expression.ĭespite major advances in care, respiratory support remains challenging for many infants hospitalized in the neonatal intensive care unit. In light of these findings, further mechanistic studies are warranted. Gene expression changes overall indicated that L-V T was associated with a qualitatively distinct inflammatory gene expression profiles compared to H-V T, which may indicate different clinical effects. No significant differences were found in IL6 and TNF expression levels. 1.3 ± 0.4-fold increase, p = 0.02) and posterior lung regions (3.0 ± 1.0-fold change increase vs. The L-V T group displayed higher IL1B mRNA expression than the H-V T group in both anterior (2.8 ± 1.5-fold increase vs. No significant differences were measured in histological inflammation scores between L-V T and H-V T lambs, although lambs in both groups exhibited slightly higher scores than the control lambs. 33 ± 7%, p = 0.3) between the L-V T and H-V T lambs. 63 ± 25 min, p = 0.5) with similar FiO 2 at 4 h post-TLV (27 ± 6% vs. All but one lamb were successfully extubated within 2 h post-TLV (72 ± 26 min vs. The anterior and posterior lung regions were assessed by a histological score and real-time quantitative PCR for IL1B, IL6, and TNF plus 12 other exploratory VILI-associated genes. The levels of respiratory support needed during the 4 h post-TLV were compared. After 4 h of TLV in the supine position, the lambs were weaned in the prone position for another 4 h. Five unventilated newborn lambs served as controls. Sixteen anesthetized and paralyzed newborn lambs were randomized in an L-V T group (initial tidal volume of 10 mL/kg at 10/min) and an H-V T group (initial tidal volume of 20 mL/kg at 5/min). Our objective was to compare lung inflammation between low (L-V T) and high (H-V T) liquid tidal volume and evaluate impacts on the weaning process. However, TLV parameters that optimally minimize VILI in newborns remain unknown. 8Department of Pediatrics, Université de Sherbrooke, Sherbrooke, QC, CanadaĪnimal experiments suggest that total liquid ventilation (TLV) induces less ventilator-induced lung injury (VILI) than conventional mechanical gas ventilation.7Department of Mechanical Engineering, Université de Sherbrooke, Sherbrooke, QC, Canada.6Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada.5Department of Pathology, Université de Sherbrooke, Sherbrooke, QC, Canada.4Department of Microbiology and Infectiology, Université de Sherbrooke, Sherbrooke, QC, Canada.3Department of Experimental Medicine, The University of British Columbia, Vancouver, BC, Canada.2BC Children’s Hospital Research Institute, The University of British Columbia, Vancouver, BC, Canada.1Department of Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada.Lavoie 2,3,6 Philippe Micheau 7 Jean-Paul Praud 1,8 Étienne Fortin-Pellerin 1,8* Michaël Sage 1 Wendy See 1 Stéphanie Nault 1 Christophe Morin 1 Christina Michalski 2,3 Benoit Chabot 4 Sofia Marouan 5 Pascal M.
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