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Airway pressure release ventilation: theory and practice.
1Maryland ExpressCare, TGR25C, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, USA.
AACN Clinical Issues
|January 5, 2002
Summary
Airway pressure release ventilation (APRV) offers improved oxygenation and CO2 removal with lower pressures. This lung-protective ventilation method may become a primary choice for acute lung injury patients.
Area of Science:
- Critical Care Medicine
- Pulmonary Medicine
- Mechanical Ventilation
Background:
- Airway pressure release ventilation (APRV) is a modern mechanical ventilation mode introduced in the mid-1990s.
- APRV utilizes a unique pressure release mechanism from an elevated baseline to facilitate both expiration and ventilation.
Purpose of the Study:
- To describe the mechanism of APRV.
- To highlight the advantages of APRV in mechanical ventilation.
- To position APRV as a lung-protective strategy.
Main Methods:
- The abstract describes the functional principles of APRV.
- It outlines the physiological effects and clinical benefits observed with APRV.
- Comparison to other ventilation modes is implicitly discussed through its unique mechanism.
Main Results:
- APRV employs timed pressure releases from a high baseline to simulate expiration.
- The elevated baseline enhances oxygenation, while timed releases assist in carbon dioxide elimination.
- Reported benefits include lower airway pressures, reduced minute ventilation, and preserved cardiovascular function.
Conclusions:
- APRV facilitates spontaneous breathing throughout the ventilatory cycle.
- It is associated with decreased sedation requirements and neuromuscular blockade.
- APRV aligns with lung protection strategies, potentially reducing ventilator-associated lung injury and supporting its use in acute lung injury.