Liquid ventilation: from experimental use to clinical application.

Despite advances in perinatal care of preterm infants, complications of prematurity are still common. If new conventional ventilatory interventions fail, ECMO is the only alternative method, but is a complex, invasive and costly technique and difficult to apply to small infants. Perfluorocarbon liquid ventilation is a promising technique. It has been demonstrated to be effective in experimental models, in mature and immature animals. However, its role in the management of human neonates, infants, older children and adults with acute respiratory failure is still not established. Both liquid ventilation strategies, total and partial, are able not only to maintain gas exchange, but also to reduce inflammatory changes. While total liquid ventilation remains as an experimental technique, partial liquid ventilation could be readily applied, but its implementation in clinical practice awaits results from ongoing and future clinical trials that may define its effectiveness.