Airway pressure-release ventilation in pregnant patients with acute respiratory distress syndrome: a novel strategy.
BACKGROUND
Airway pressure-release ventilation (APRV) is a novel mode of positive-pressure ventilation that has several advantages over low-tidal-volume, assist-control ventilation in patients with acute respiratory distress syndrome, specifically, lower airway pressures, lower minute ventilation, minimal effects on cardio-circulatory function, ability to spontaneously breathe throughout the entire ventilatory cycle, and decreased sedation requirements. APRV is consistent with lung-protective strategies that aim to limit lung injury associated with mechanical ventilation. APRV utilization in obstetrical patients has not previously been reported.


METHODS
We present 2 cases of pregnant women with severe life-threatening ARDS who were successfully managed with APRV.


CONCLUSIONS
APRV may have particular utility in pregnant patients with ARDS. We believe APRV was life-saving in our cases. APRV ventilation should be considered in pregnant patients with ARDS.
Hirani
Amyn
A
Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Marik
Paul E
PE
Plante
Lauren A
LA
D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D055815:Young Adult