Hemodynamic changes in child acute respiratory distress syndrome with airway pressure release ventilation: a case series.
BACKGROUND
Airway pressure release ventilation (APRV) is widely used in adult critical care settings. However, information on the use of APRV in the pediatric population is limited.


METHODS
All patients admitted to the medical-surgical pediatric intensive care unit with a diagnosis of acute respiratory distress syndrome (ARDS) who received APRV for at least 12 h between 2007 and 2009 were reviewed.


RESULTS
Thirteen patients with a variety of etiologies of ARDS were included, with a mean weight of 18.2 ± 15.0 kg, a mean age of 68 ± 57 months and a predicted mortality (based on Pediatric Index of Mortality version 2) of 23.9 ± 13.8%. Patients were placed on APRV for a median of 4 days (range 1-10 days). There was no change in blood gas parameters after 1 h or 12 h of APRV when compared with pre-APRV. There was no statistical difference in hemodynamic parameters, including mean arterial blood pressure, central venous blood pressure and heart rate, while the patients were on APRV.


CONCLUSIONS
APRV could be safely used in pediatric ARDS patients, without significant hemodynamic compromise or side effects.
Department of Pediatrics, Pediatric Critical Care Medicine, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.|School of Public Health, University of Alberta, Edmonton, Canada.|Division of Pediatric Critical Care, Pediatric Intensive Care Unit, Shizuoka Children's Hospital, Shizuoka, Japan.
Atsushi
A
Kawaguchi
Department of Pediatrics, Pediatric Critical Care Medicine, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.
Gonzalo Garcia
GG
Guerra
Department of Pediatrics, Pediatric Critical Care Medicine, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.
Jonathan P
JP
Duff
Division of Pediatric Critical Care, Pediatric Intensive Care Unit, Shizuoka Children's Hospital, Shizuoka, Japan.
Ikuya
I
Ueta
Division of Pediatric Critical Care, Pediatric Intensive Care Unit, Shizuoka Children's Hospital, Shizuoka, Japan.
Ryosuke
R
Fukushima
D056586:Acute Chest Syndrome / Q000503:physiopathology* / Q000628:therapy*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D008297:Male; D011659:Pulmonary Gas Exchange; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
acute respiratory distress syndrome; airway pressure release ventilation; children; spontaneous breathing