In acute respiratory distress syndrome, neutrophil migration into the lung plays a key role in the development of lung injury. To study the effect of different modes of ventilation with perfluorocarbon (FC77), intrapulmonary neutrophil accumulation and mRNA expression of E-selectin, P-selectin and intercellular adhesion molecule-1 (ICAM-1), mediating leukocyte sequestration, were measured in surfactant depleted piglets. After bronchoalveolar lavage, 20 animals either received aerosolized perfluorocarbon (Aerosol-PFC), partial liquid ventilation (PLV) with perfluorocarbon at functional residual capacity filling volume (FRC-PLV) or at low volume (LV-PLV) or intermittent mandatory ventilation (control). After 2 h of perfluorocarbon application, intermittent mandatory ventilation was continued for 6 h. In the Aerosol-PFC group, all measured adhesion molecules showed a significantly reduced gene expression compared to controls. FRC-PFC treatment was effective in significantly diminishing P-selectin and ICAM-1 mRNA expression. Relative lung tissue neutrophil counts were significantly reduced in the Aerosol-PFC and the FRC-PLV group. Treatment with aerosolized perfluorocarbon is at least as effective as partial liquid ventilation at FRC volume in reducing pulmonary adhesion molecule expression and neutrophil accumulation in acute respiratory distress syndrome.