Partial Liquid Ventilation for Critically Ill Newborns

Resident and newborn.
Innovations in applying liquid breathing treatment give extremely premature infants a better chance for survival.

In the mid-1990s, pediatric critical care doctors at UB developed a revolutionary technique called partial liquid ventilation (PLV) to treat respiratory distress syndrome (RDS), a common, often fatal complication seen in premature infants. RDS develops because the lungs of these tiny babies have yet to secrete surfactant, the substance that prevents the air sacs from collapsing.

Prior to the development of PLV, conventional therapy involved increasing the pressure and oxygen concentration inside a baby’s lungs in an effort to force more oxygen into the blood stream. This sometimes caused permanent lung damage and resulted in a chronic disease called bronchopulmonary dysplasia.

PLV introduces an oxygen-rich liquid called perflubron into the baby’s lungs. The liquid allows the lungs to inflate with less pressure than air, and permits oxygen and carbon dioxide to pass through the air sacs and into the blood stream more easily and efficiently.

Reaching this milestone took approximately 30 years. One of the major barriers to clinical application around the world was the fact that liquid breathing required a highly specialized ventilator.

Bradley Fuhrman, MD, a UB professor of pediatrics and anesthesia and chief of pediatric critical care at Women and Children’s Hospital of Buffalo, simplified the entire process by discovering a way to apply liquid breathing using a standard hospital ventilator.

Today, PLV (sometimes known as perfluorcarbon-associated gas exchange, or PAGE), also is used to treat children and adults with severe respiratory distress syndrome.

In 2004, Fuhrman received the Distinguished Career Award from the American Academy of Pediatrics.