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Vol. 24, Art. 93 (pp. 1368-1397)    |    2023       

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Perfluorocarbons in the treatment of severe bronchopulmonary pathology. part i: classification of methods (Analytical review)

Bonitenko E.U.,1,2,4 Belyakova N.A.,2 Barinov V.A.,2 Krasnov К.А.,2 Gladchuk A.S.,2
Burov A.A.,3 Tonshin A.A.,1 Isabekov N.R.1

1Federal State Budgetary Science Institution «Scentific institute of occupational medicine named after academician N.F. Izmerova»
105275, Moskva, pr. Budennogo, 31
2Federal State Budgetary Institution «Scientific and Clinical Center of Toxicology named after academician S.N. Golikov of the Federal Medical and Biological Agency
192019, Sankt-Peterburg, str. Behtereva, 1
3Federal State Budgetary Institution "National Medical Research Center of Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov" of the Ministry of Health of Russia
117997, Moscow, st. Academician Oparin, 4
4Federal State Autonomous Educational Institution of Higher Education «Sevastopol State University»
299053. Sevastopol, Universitetskaya str, 33

Brief summary

Introduction. Despite more than forty years of studying of the use of perfluorocarbons (PFCs) for medical purposes, including for the treatment of severe bronchopulmonary pathology (BPP), we have not been able to find any works devoted to the systematization of these methods in the literature. The aim of the study is to develop approaches to systematization of promising and existing methods for the use of PFCs for the treatment of severe BPP, based on the analysis of literature and our experimental data. Materials and methods. Russian and foreign scientific publications identified as a result of a search in scientific electronic libraries were used as materials. The main research method was the generalization and analysis of available literature and own experimental data on the methods of using PFC in the treatment of severe BPP in adults and newborns. Outcomes. PFCs are a group of synthetic, fully fluorinated organic compounds in which all hydrogen atoms are replaced by fluorine. Due to the predominance of strong C-F bonds in molecules, PFCs have almost complete chemical inertness and resistance to any influences, including metabolic transformations in the body. However, the uniqueness of PFCs is determined by their gas-transporting properties, especially in relation to respiratory gases (oxygen and carbon dioxide), which attracted the attention of specialists at the first stage of their study. The use of PFCs in clinical practice in the treatment of severe BPP is currently limited of the use of bronchoalveolar lavage in the treatment of acute respiratory failure caused by lower airway obstruction. The high hopes associated with the use of partial liquid ventilation (LV) in the treatment of respiratory distress syndrome in adults, children and newborns have not yet been met. There are also certain difficulties with the introduction of a common LV is conditioned, on the one hand, by the reliability of the hardware of the method, and on the other hand, by the lack of a concept of its application in the treatment of severe BPP. The interest in increasing of the therapeutic breadth and effectiveness of total LV is its combination with physical factors such as hypothermia and overpressure. In our opinion, this direction is the most promising in terms of further introduction of total LV into clinical practice, as well as the use of aerosols of PFCs. We should also not forget about the methods of targeted drug delivery to the lungs using PFCs, which are still being actively developed, but only within the framework of preclinical studies. The developed classification of the use of PFCs for the treatment of severe BPP includes five main groups of methods: bronchoalveolar lavage, gas-liquid artificial ventilation, liquid ventilation, inhalation of PFCs, targeted delivery of drugs to the lungs. Conclusion. The classification of methods for the use of PFCs in medicine in the treatment of severe BPP, presented by us in this work, is the first of its kind, which allows not only to systematize the existing methods of experimental therapy, but also to determine the prospects for their further development and subsequent implementation in clinical practice.


Key words

perfluorocarbon, perfluorodecalin, perflubron, bronchoalveolar lavage, liquid ventilation, total liquid ventilation, partial liquid ventilation

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