title: The effect of APRV ventilation on ICP and cerebral hemodynamics.
abstract: BACKGROUND
  Airway pressure release ventilation (APRV) is an alternative approach to the low-tidal volume "open-lung" ventilation strategy. APRV is associated with a higher mean airway pressure than conventional ventilation and has therefore not been evaluated in patients with acute neurological injuries.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  We report a patient with severe progressive hypoxemia following a subarachnoid hemorrhage who was converted from pressure-controlled mechanical ventilation to APRV. This change in ventilatory mode was associated with a significant improvement in oxygenation and alveolar ventilation with an associated increase in cerebral blood flow and a negligible increase in intracranial pressure.
  
  
  CONCLUSIONS
  APRV may safely be applied to neurocritically ill patients, and that this mode of ventilation may increase cerebral blood flow without increasing intracranial pressure.
authors: Division of Pulmonary and Critical Care Medicine, Department of Respiratory Services, Eastern Virginia Medical School, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507, USA. marikpe@evms.edu
authors: Paul E
authors: PE
authors: Marik
authors: Alisha
authors: A
authors: Young
authors: Steve
authors: S
authors: Sibole
authors: Alex
authors: A
authors: Levitov
mesh_terms: D000368:Aged; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000628:therapy*; D007427:Intracranial Pressure; D012039:Regional Blood Flow; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D013345:Subarachnoid Hemorrhage / Q000628:therapy*