Reduction of peak inflation and positive end-expiratory pressure using pressure control with inverse-ratio ventilation: a case report.
Pressure control with inverse-ratio ventilation (PcIRV) has been shown to reduce peak inspiratory pressure (PIP) and positive end-expiratory pressure while providing adequate oxygenation and ventilation. This case of a 39-year-old man with a perforated colon who required high PIP after surgery demonstrates the effectiveness of PcIRV in reducing PIP from 72 cm H2O to 44 cm H2O and reducing positive end-expiratory pressure from 24 cm H2O to 6 cm H2O. A maximum inverse ratio of 3:1 was established to achieve a PaO2 of 105 mm Hg and PaCO2 of 37 mm Hg. In this case, the mean airway pressure rose from 32 cm H2O with assist-control ventilation to 39 cm H2O with PcIRV at 3:1. Cardiac output decreased from 9.11 L/min to 8.35 L/min with PcIRV at a 3:1 inspiratory/expiratory ratio.
Lain
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Department of Respiratory Care, Medical College of Georgia, Augusta 30912-5300.
Mansberger
L A
LA
Thorarinsson
B
B
Lewis
L A
LA
D000328:Adult; D006801:Humans; D008297:Male; D011175:Positive-Pressure Respiration / Q000379:methods*; D012123:Pulmonary Ventilation; D012121:Respiration, Artificial / Q000379:methods*