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1 CardioPulmonary Research Institute, Departments of 2 Thoracic Cardiovascular Surgery, 3 Pediatrics, 6 Pathology, and 8 Medicine, Winthrop University Hospital, State University of New York at Stony Brook School of Medicine, Mineola, New York 11501; 7 Department of Biology, Queens College, Flushing, New York 11367; 4 Department of Physiology, Temple University School of Medicine, Philadelphia, Pennsylvania 19122; and 5 Heart and Lung Institute, Jewish Hospital, University of Louisville School of Medicine, Louisville, Kentucky 40202
To determine whether liquid ventilation (LV) causes less cell injury and improves lung function compared with conventional gas ventilation (GV), we analyzed pulmonary physiological profiles, lung histology, and cell death in 110- and 120-day preterm lambs, which were randomized to receive either ventilation modality on FIO2 = 1. LV lungs were well expanded with adequate pulmonary function, whereas GV animals exhibited marked atelectasis, poor pulmonary function, and increased mortality. Both ventilatory strategies induced marked lung cell apoptosis, but with distinct patterns of distribution. Although GV induced apoptosis of epithelium primarily in the lining and within the lumina of bronchioles, LV induced significant apoptosis much more homogeneously throughout lung parenchyma including alveoli and interstitial spaces. These studies suggest that although both forms of ventilation cause regional apoptosis, LV more effectively delivers oxygen and recruits the lung more homogeneously than GV.
hyperoxia; epithelial cells; preterm; cell injury; cell death
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