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Nocentini G, MacLaren G, Bartlett R, De Luca D, Perdichizzi S, Stoppa F, Marano M, Cecchetti C, Biasucci DG, Polito A, AlGhobaishi A, Guner Y, Gowda SH, Hirschl RB, Di Nardo M. Perfluorocarbons in Research and Clinical Practice: A Narrative Review. ASAIO J 2023; 69:1039-1048. [PMID: 37549675 DOI: 10.1097/mat.0000000000002017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Perfluorocarbons (PFCs) are organic liquids derived from hydrocarbons in which some of the hydrogen atoms have been replaced by fluorine atoms. They are chemically and biologically inert substances with a good safety profile. They are stable at room temperature, easy to store, and immiscible in water. Perfluorocarbons have been studied in biomedical research since 1960 for their unique properties as oxygen carriers. In particular, PFCs have been used for liquid ventilation in unusual environments such as deep-sea diving and simulations of zero gravity, and more recently for drug delivery and diagnostic imaging. Additionally, when delivered as emulsions, PFCs have been used as red blood cell substitutes. This narrative review will discuss the multifaceted utilization of PFCs in therapeutics, diagnostics, and research. We will specifically emphasize the potential role of PFCs as red blood cell substitutes, as airway mechanotransducers during artificial placenta procedures, as a means to improve donor organ perfusion during the ex vivo assessment, and as an adjunct in cancer therapies because of their ability to reduce local tissue hypoxia.
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Affiliation(s)
- Giulia Nocentini
- From the Academic Department of Pediatrics (DPUO), Immune and Infectious Diseases Division, Research Unit of Primary Immunodeficiencies, IRCCS Bmbino Gesù Children's Hospital, Rome, Italy
| | - Graeme MacLaren
- Cardiothoracic Intensive Care Unit, National University Health System, Singapore
| | - Robert Bartlett
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
| | | | - Francesca Stoppa
- Pediatric Intensive Care Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - Marco Marano
- Pediatric Intensive Care Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - Corrado Cecchetti
- Pediatric Intensive Care Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
| | - Daniele G Biasucci
- Department of Clinical Science and Translational Medicine, "Tor Vergata" University of Rome, Rome, Italy
| | - Angelo Polito
- Pediatric Intensive Care Unit, Department of Woman, Child, and Adolescent Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Abdullah AlGhobaishi
- Pediatric Critical Care Unit, Department of Pediatrics, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Yit Guner
- Department of Pediatric Surgery, Children's Hospital of Orange County and University of California Irvine, Orange, California
| | - Sharada H Gowda
- Departments of Surgery and Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Ronald B Hirschl
- Section of Pediatric Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Matteo Di Nardo
- Pediatric Intensive Care Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy
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Degnan AJ, Zhu X, Flowers C, Fox WW, Zhang H, Saul D. Imaging Assessment of Partial Liquid Ventilation in Bronchopulmonary Dysplasia. Curr Probl Diagn Radiol 2019; 48:247-250. [DOI: 10.1067/j.cpradiol.2018.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/15/2018] [Accepted: 12/05/2018] [Indexed: 11/22/2022]
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Tak S, Barraclough M. 'Pseudo-calcifications': detection of perfluorocarbon residue on a computed tomography scan 15 years after liquid ventilation therapy at 3 months of age. BMJ Case Rep 2018; 2018:bcr-2017-223958. [PMID: 29507033 DOI: 10.1136/bcr-2017-223958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Partial liquid ventilation using perfluorocarbons is a therapy that was once frequently used in paediatric populations for patients with severe respiratory distress. Perfluorocarbon is a non-toxic, insoluble and radiopaque vector through which improved gas exchange can occur. Two previous cases have been reported of persistent perfluorocarbon residua, identified on imaging years after receiving liquid ventilation therapy. We report a case of perfluorocarbon detection on a CT scan 15 years after liquid ventilation at 3 months of age, and propose the probable mechanism of its appearance. The importance of considering the imaging appearances of 'pseudo-calcifications' as a long-term sequela to perfluorocarbon liquid ventilation is emphasised.
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Affiliation(s)
- Sameem Tak
- Department of Paediatrics, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | - Mary Barraclough
- Department of Paediatrics, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
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Servaes S, Epelman M. Perflubron residua: 12 years following therapy. Pediatr Radiol 2009; 39:393-5. [PMID: 19189093 DOI: 10.1007/s00247-008-1139-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2008] [Revised: 11/24/2008] [Accepted: 12/23/2008] [Indexed: 11/28/2022]
Abstract
Partial liquid ventilation therapy utilizing perfluorocarbons has been used for patients with severe respiratory distress. Perfluorocarbons such as perflubron have been demonstrated to clear from the lungs shortly after therapy. We present a 13-year-old boy with residual perflubron in his lungs, 12 years following therapy with perflubron. The imaging features are important to recognize as these patients return for additional care and imaging.
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Affiliation(s)
- Sabah Servaes
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4399, USA.
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