Inverse ratio ventilation in ARDS. Improved oxygenation without autoPEEP.
Inverse ratio ventilation and related ventilatory modes (eg, pressure release ventilation) have been applied to patients with the adult respiratory distress syndrome (ARDS) with apparent beneficial effects on arterial oxyhemoglobin saturation. While several mechanisms of improved gas exchange have been postulated, many intensive care physicians believe that the development of occult PEEP (autoPEEP; intrinsic PEEP) leads to the observed rise in oxygen saturation. We report here our findings in a patient whose improved oxygenation on inverse ratio ventilation could not be attributed to autoPEEP.
Manthous
C A
CA
Section of Pulmonary and Critical Care Medicine, University of Chicago.
Schmidt
G A
GA
D000293:Adolescent; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015479:Leukemia, Myelomonocytic, Acute / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D010100:Oxygen / Q000097:blood*; D011175:Positive-Pressure Respiration; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*
D010100:Oxygen