2002, Number 5
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ABSTRACTAcute respiratory deficiency syndrome with refractory hypoxemia, alveolar collapse, edema and hemorrhage produces pulmonary hypertension, reduced distensibility and, if not appropriately corrected, leads to death. There are various ventilation ventilation techniques: control of pressure and volume, by positive pressure at the end of expiration, by replacement of the surfactants or by extracorporeal oxygenation. However, none of these modify the basic physiopathological disruption.
In 1950, Stein postulated that gaseous interchange could not only occur at the air/liquid alveolar interface, but also at the liquid/liquid interface. This was demonstrated in rats, which breathed a perfluorocarbonated solution in normobaric conditions allowing a good diffusion of oxygen and carbon dioxide.
Perflurocarbons are dense liquids, radiopaques, non-toxic and biocompatible with a great capacity to diffuse oxygen and carbon dioxide due to their low superficial tension and wide distribution; they have an anti-inflammatory effect, do not produce atelectasis, remove proteic detritus cells, are partially bactericides and facilitate surfactant action.
The ventilator operates using a previously oxygenated solution of prefluorocarbons and ventilation can be total or partial, the latter being used more in practice. The overall procedure, although complex and expensive, is very useful. Once it has been applied and improvement obtained, a return to conventional ventilation is simple with the PFC’s being eliminated within 48-72 hours.
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