Utilizing the peritoneum for gas exchange with oxygenated perfluorocarbons

Abstract Introduction: This pilot study attempted to determine if it was possible to deliver a clinically significant amount of oxygen to a large animal, with induced hypoxia, by perfusing the abdomen with oxygenated perfluorocarbons. Methods: 15 pigs weighing 45 to 55 kg were rendered hypoxic by ventilating them with a blend of nitrogen and oxygen to achieve sub-atmospheric inspired oxygen concentrations (FiO 2 ) ranging from 18–10%, resulting in baseline arterial oxygen pressures (PaO 2 ) of 65.9 ± 9.7 mmHg to 26.6 ± 2.8 mmHg, respectively. Peritoneal perfusion was then performed in 8 animals with oxygenated perfluorocarbon and 7 with oxygenated saline. This study was approved by the IACUC. Results: The average increase in PaO 2 with oxygenated perfluorocarbon perfusion ranged from 8.1 to 18.2 mmHg. A common treatment effect of 12.8 mmHg (95% CI=7.4 to 18.2; p-value 2 values, representing the average mean difference in oxygen uptake between PFC and saline when oxygenation was on, irrespective of the level of FiO 2 . The most clinically relevant results occurred at a FiO 2 of 14%, resulting in a baseline PaO 2 of 39.4 ± 5.0 mmHg, but increasing to 55.3 ± 7.6 mmHg with oxygenated perfluorocarbon perfusion. Control experiments with oxygenated saline did not demonstrate any significant gas exchange effects. Conclusions: The peritoneal cavity can be used for gas exchange and, in our model, yielded clinically relevant quantities of supplemental oxygen. This technique may have potential for supportive care of patients dying from hypoxia in the setting of a reversible lung injury.