Grant: Proof of Principle Program - Phase I

During labor and delivery, the first stool of the newborn (the meconium) can contaminate the amniotic fluid and subsequently be inhaled deep into the lungs causing meconium aspiration syndrome (MAS). These infants are usually transferred to a regional neonatal intensive care unit (NICU). Recent literature data suggest a radical change in the treatment of MAS by considering the use of total liquid ventilation (TLV). With this method, the lungs are completely filled with a perfluorocarbon liquid (PFC) while a dedicated liquid ventilator ensures the renewal of a tidal volume of liquid. Following 10 years of research and development, we have acquired a unique expertise in TLV by using our own designed and patented liquid ventilator, which is one of the most advanced in the world.The objective of the present research is to demonstrate that severe MAS can be successfully treated with TLV. NICU conditions will be reproduced to validate the efficiency of meconium lung lavage by TLV, from onset to weaning to spontaneous air ventilation. The most effective impact will be to introduce a new method of respiratory support allowing for a less aggressive lung lavage in newborns. This ventilatory approach will constitute an alternative to ECMO for the sickest newborns as well as for those with a contraindication to ECMO. Moreover, the introduction of an efficient liquid ventilator in NICUs will allow its use as an alternate respiratory support in all cases of severe neonatal respiratory distress. On the long term, we will consider TLV in the treatment of acute respiratory distress syndrome (ARDS) where mortality and morbidity rates remain unacceptably high in adults and children (an incidence of 10-14 cases per 100 000 habitants per year and a mortality rate of 31% in developed countries).