Chest
Laboratory and Animal Investigations: ArticlesDoes Airway Pressure Release Ventilation Alter Lung Function After Acute Lung Injury?
Section snippets
Methods
After approval from the University of South Florida Institutional Animal Care and Use Committee, swine of either sex were sedated with ketamine hydrochloride (30 mg/kg intramuscularly) and anesthetized with enflurane and oxygen to facilitate tracheal intubation and instrumentation. After instrumentation, anesthesia was maintained with an intravenous infusion of ketamine hydrochloride (28 mg/kg/h). A sample tube from a capnometer was attached between the pneumotachograph and breathing circuit
Results
Central venous infusion of oleic acid reduced PaO2 from 94 ± 4 mm Hg to 52 ± 9 mm Hg (p<0.001) and dynamic lung compliance from 40 ± 6 mL/cm H2O to 20 ± 6 mL/cm H2O (p=0.002) and increased intrapulmonary venous admixture from 13 ± 3% to 32 ± 7% (p<0.001) while ten pigs breathed spontaneously at atmospheric pressure (FIo2=0.21). Pulmonary and hemodynamic data obtained after acute lung injury while pigs breathed spontaneously at atmospheric pressure before and after alternating periods of CPAP
Discussion
Optimizing alveolar ventilation with application of the least possible positive airway pressure is an important goal in the mechanical ventilatory management of patients with impaired pulmonary function. Airway pressure release ventilation is a ventilatory support technique designed to augment alveolar ventilation of subjects who require ventilatory assistance, despite improved pulmonary mechanics and oxygenation with CPAP.1, 5, 6 During APRV, airway pressure is decreased, gas exits the lungs,
ACKNOWLEDGMENTS
The authors appreciated use of the computerized pulmonary work station with physiologic pattern recognition software developed by Mauricio Leon, MD, technical assistance of Michael R. Hodges, and editorial assistance of John B. Downs, MD.
References (6)
- et al.
Cardiovascular effects of conventional positive pressure ventilation and airway pressure release ventilation
Chest
(1988) - et al.
Airway pressure release ventilation: a new concept in ventilatory support [editorial]
Crit Care Med
(1987) - et al.
Airway pressure release ventilation
Crit Care Med
(1987)
Cited by (14)
Airway pressure release ventilation
2013, Current Problems in SurgeryCitation Excerpt :Alternatively, in a closed circuit pressure-control mode, exhalation cannot occur unless pressure limiting is reached causing patient asynchrony and discomfort. By combining diffusive and convective gas exchange, APRV provides a more efficient form of ventilation requiring less minute ventilation for equivalent CO2 clearance.33-38 As lung volume is maintained during the CPAP phase, cardiac output delivers CO2 to diffuse into the lung (distal airspace) and oxygen into the blood.
What Is the Role of Airway Pressure Release Ventilation in the Management of Acute Lung Injury?
2006, Respiratory Care Clinics of North AmericaCitation Excerpt :The use of APRV may have potential advantages over the use of conventional ventilation. First, several studies have shown that lower airway pressures are required to achieve adequate oxygenation without hemodynamic compromise [11–15]. Second, as in the scenario of inverse ratio ventilation (IRV), APRV uses extended high pressure levels to optimize the use of mean airway pressure (mPaw), leading to a increased lung volume.
Myths and Misconceptions of Airway Pressure Release Ventilation: Getting Past the Noise and on to the Signal
2022, Frontiers in PhysiologyA Ventilator Mode Cannot Set Itself, Nor Can It Be Solely Responsible for Outcomes
2022, Critical Care MedicineThe 30-year evolution of airway pressure release ventilation (APRV)
2016, Intensive Care Medicine ExperimentalAirway pressure release ventilation. Current concepts
2016, Medicina Interna de Mexico