Airway Pressure-Release Ventilation in Pregnant Patients With Acute Respiratory Distress Syndrome: A Novel Strategy

BACKGROUND: Airway pressure-release ventilation (APRV) is a novel mode of positive-pressure ventilation that has several advantages over low-tidal-volume, assist-control ventilation in patients with acute respiratory distress syndrome, specifically, lower airway pressures, lower minute ventilation, minimal effects on cardio-circulatory function, ability to spontaneously breathe throughout the entire ventilatory cycle, and decreased sedation requirements. APRV is consistent with lung-protective strategies that aim to limit lung injury associated with mechanical ventilation. APRV utilization in obstetrical patients has not previously been reported.

CASES: We present 2 cases of pregnant women with severe life-threatening ARDS who were successfully managed with APRV.

CONCLUSIONS: APRV may have particular utility in pregnant patients with ARDS. We believe APRV was life-saving in our cases. APRV ventilation should be considered in pregnant patients with ARDS.