Cardiorespiratory effects of pressure controlled inverse ratio ventilation in severe respiratory failure

Cardiorespiratory values were measured in nine patients with severe respiratory failure before and following initiation of pressure controlled inverse ratio ventilation (PC-IRV) at an inspiratory to expiratory ratio of 2:1. All patients showed increases in PaO2, with the mean PaO2 rising from 63 +/- 4 (mean +/- SEM) to 76 +/- 8 mm Hg. Peak inspiratory pressure fell from 44 +/- 4 to 39 +/- 2 cm H2O. There were no significant changes in any hemodynamic or oxygen metabolism variable associated with the institution of PC-IRV. In particular, no significant alteration in cardiac index, pulmonary artery pressures, oxygen delivery, oxygen consumption, or oxygen extraction ratio occurred with the use of PC-IRV. These results suggest that PC-IRV may be a useful ventilatory modality in the treatment of severe respiratory failure since it results in improvement in arterial oxygenation without any deterioration in hemodynamic or tissue oxygen metabolism parameters.