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Chest, Vol 100, 460-463, Copyright © 1991 by American College of Chest Physicians

ARTICLES

Airway pressure release ventilation in severe acute respiratory failure

RD Cane, WT Peruzzi and BA Shapiro
Department of Anesthesia, Northwestern University Medical School, Chicago.

Airway pressure release ventilation (APRV), a new ventilatory support technique, was compared with conventional intermittent positive- pressure ventilation plus PEEP (CPPV) in 18 patients with severe acute respiratory failure. Patients were initially stabilized on CPPV and then switched to APRV. The APRV provided effective ventilatory support in 17 of 18 patients; APRV achieved similar levels of alveolar ventilation as CPPV (for APRV, mean PaCO2 = 45.0 +/- 6.2 mm Hg; vs for CPPV, mean PaCO2 = 43.3 +/- 5.7 mm Hg), with significantly lower mean maximum airway pressures (38.9 +/- 10.1 cm H2O vs 64.6 +/- 15.4 cm H2O; p = 0.0001) and mean VT (0.79 +/- 0.11 L vs 1.05 +/- 0.15 L; p = 0.0002). No significant differences in mean airway pressure, end- expiratory pressure, FIO2, ventilator rate, arterial blood gas levels, and hemodynamic function were noted between APRV and CPPV.


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Copyright © 1991 by the American College of Chest Physicians.