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Does airway pressure release ventilation alter lung function after acute lung injury?
1Department of Anesthesiology, University of South Florida College of Medicine, Tampa.
Chest
|March 1, 1995
Summary
Airway pressure release ventilation (APRV) maintains oxygenation and lung mechanics in acute lung injury. This study found APRV does not worsen outcomes compared to continuous positive airway pressure (CPAP) alone.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
- Mechanical Ventilation
Background:
- Airway Pressure Release Ventilation (APRV) involves tidal ventilation between continuous positive airway pressure (CPAP) and relaxation volume.
- Concerns exist that CPAP release during APRV may cause alveolar collapse and impaired re-inflation.
Purpose of the Study:
- To compare pulmonary mechanics and oxygenation in animals with acute lung injury receiving CPAP with and without APRV.
Main Methods:
- An experimental, randomized crossover study in ten pigs with induced acute lung injury.
- APRV and CPAP were applied and titrated to maintain arterial oxyhemoglobin saturation.
- Pulmonary and systemic hemodynamics, blood gases, and respiratory mechanics were measured.
Main Results:
- APRV maintained intrapulmonary venous admixture, arterial oxyhemoglobin saturation, and oxygen delivery comparable to CPAP.
- A slight decrease in PaO2 during APRV was attributed to increased pHa and decreased PaCO2, not pulmonary function deterioration.
- No significant differences in hemodynamic variables or lung mechanics were observed between CPAP and APRV.
Conclusions:
- APRV effectively maintains oxygenation and oxygen delivery in acute lung injury without compromising lung mechanics.
- Periodic airway pressure release in APRV does not lead to significant deterioration in oxygenation or pulmonary function.
- APRV is a viable ventilation strategy for patients with acute lung injury.