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ID 34971
file
creator
Liu, Liangji
Ota, Kohei
Tamura, Tomoko
Yamaga, Satoshi
Kida, Yoshiko
Kondo, Tomohiro
Ishida, Makoto
Tsumura, Ryu
Takeda, Taku
subject
Acute respiratory distress syndrome
Airway pressure release ventilation
Mechanical ventilation
NDC
Medical sciences
abstract
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.
journal title
Hiroshima Journal of Medical Sciences
volume
Volume 58
issue
Issue 4
start page
83
end page
88
date of issued
2009-12
publisher
Hiroshima University Medical Press
issn
0018-2052
ncid
language
eng
nii type
Departmental Bulletin Paper
HU type
Departmental Bulletin Papers
DCMI type
text
format
application/pdf
text version
publisher
rights
(c) Hiroshima University Medical Press.
department
Graduate School of Biomedical Science
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