Airway pressure release ventilation (APRV). A human trial.
After operative coronary revascularization, 14 consenting adults received conventional positive pressure ventilation (PPV). When they were hemodynamically stable, data were collected during PPV and then during airway pressure release ventilation (APRV). During APRV, airway pressure (Paw) was reduced periodically at the lowest frequency which produced normal PaCO2. As anesthesia resolved, the rate of APRV breaths was decreased until patients breathed only with CPAP. During PPV and APRV, pHa, PaO2/FIO2, and hemodynamic variables were similar. All patients were weaned from APRV without complication. Optimal ventilator design for patients with acute lung injury would provide CPAP as a primary intervention and secondarily would augment alveolar ventilation. The APRV supported oxygenation and ventilation in patients with mild acute lung injury, yet with much lower peak airway pressure than produced by PPV.
D000403:Airway Resistance; D002245:Carbon Dioxide / Q000097:blood; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D006801:Humans; D008171:Lung Diseases / Q000209:etiology / Q000628:therapy; D010100:Oxygen / Q000097:blood; D011175:Positive-Pressure Respiration; D011182:Postoperative Care; D012121:Respiration, Artificial / Q000379:methods*; D014655:Vascular Resistance
D002245:Carbon Dioxide; D010100:Oxygen