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Inolivent : «InNOvative LIquid VENTtilation»

A radical change in respiratory support is suggested by literature data; replacing gas with a breathable perfluorocarbon liquid (PFC). TLV is an ideal method of respiratory support in acute lung injury, especially when therapeutic lung lavage is required. By eliminating the air-liquid interface, TLV, as a respiratory support in acute lung injury, allows recruitment of collapsed lung regions at lower pressure and ensures more homogeneous alveolar ventilation, hence decreasing the risk of additional ventilator-induced lung injury. TLV also reduces ventilation/perfusion mismatches by redistributing pulmonary blood flow and ventilation to nondependent regions of the injured lungs. Other demonstrated advantages of TLV include the in vitro as well as in vivo anti-inflammatory, anti-oxidant and anti-bacterial effects of PFC, as well as a bronchoalveolar lavaging effect.

The total liquid ventilation (TLV) necessitates a dedicated mechanical system in order to ventilate completely filled lungs with a tidal volume of perfluorocarbon liquid. The objective of the Inolivent research group is to develop a liquid ventilator in order to move the total liquid ventilaion from bench to bedside. An international panel of experts strongly recommends to develop a liquid ventilator for clinical applications due to the large number of studies in various animal models of severe respiratory failure showing clear benefits from TLV versus all other tested ventilation strategies. Besides the respiratory support, TLV also has the therapeutic potential to perform an effective therapeutic lung lavage as well as to be used as a heat exchanger for therapeutic hypothermia. But, at Sherbrooke, we believe that  TLV should be first tried as the last resort therapy for newborns with severe neonatal respiratory failure, in which all available conventional treatments have failed and who are not eligible for ECMO.