Practical Use of Airway Pressure Release Ventilation for Severe ARDS : a preliminary report in comparison with a conventional ventilatory support

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タイトル ( eng )
Practical Use of Airway Pressure Release Ventilation for Severe ARDS : a preliminary report in comparison with a conventional ventilatory support
作成者
Liu Liangji
Ota Kohei
Tamura Tomoko
Yamaga Satoshi
Kida Yoshiko
Kondo Tomohiro
Ishida Makoto
Tsumura Ryu
Takeda Taku
収録物名
Hiroshima Journal of Medical Sciences
58
4
開始ページ 83
終了ページ 88
収録物識別子
[PISSN] 0018-2052
[EISSN] 2433-7668
[NCID] AA00664312
抄録
Airway pressure release ventilation (APRV) is a ventilatory mode that allows unsupported spontaneous breathing at any phase of the ventilatory cycle with high mean airway pressures. We hypothesized that use of APRV might produce potential beneficial effects on oxygenation, reducing mortality in patients with severe acute respiratory distress syndrome (ARDS) in comparison with synchronized intermittent mandatory ventilation (SIMV) as a conventional mode of ventilation. We retrospectively reviewed data of 58 patients with severe ARDS (the ratios of partial arterial oxygen tension to fraction of inspired oxygen, PaOz/F102 ratio <150). The patients' data were divided into two groups: SIMV-group and APRV-group. Patients' backgrounds, oxygenation on day 0, 1, 3, 5 and 7 following initiation of each mode, vasopressor dependence, duration of ventilation, duration of ICU stay, and mortality in ICU were analyzed. PaOz/F102 ratios were statistically higher in the APRV-group (APRV vs. SIMV on day 1, 3, 5, 7: 201.6 ± 76 vs.150 ± 59.1, 256.7 ± 71.5 vs.182.1 ± 65.4, 268.8 ± 73.3 vs. 204.6 ± 72.8, and 263 ± 74.5 vs.204.1 ± 67.1, respectively, p<0.05). Vasopressors were less used (p=0.018), and mortality in ICU tended to be lower in the APRV group (31 %) than in the SIMV group (59%) (p=0.050).
Use of APRV in patients with severe ARDS appears to be associated with improvements in oxygenation, and a trend toward lower mortality in ICU. No significant adverse effects were observed. Prospective controlled studies are required to confirm the benefits of this ventilatory mode in comparison with conventional methods for severe ARDS.
著者キーワード
Acute respiratory distress syndrome
Airway pressure release ventilation
Mechanical ventilation
NDC分類
医学 [ 490 ]
言語
英語
資源タイプ 紀要論文
出版者
Hiroshima University Medical Press
発行日 2009-12
権利情報
(c) Hiroshima University Medical Press.
出版タイプ Version of Record(出版社版。早期公開を含む)
アクセス権 オープンアクセス
収録物識別子
[ISSN] 0018-2052
[NCID] AA00664312