Abstract
Background: Acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality. Airway pressure release ventilation (APRV) was suggested to be a suitable mode for ventilating such patients with less liability of lung injury.
Aim: to compare the effect of APRV and pressure control ventilation (PCV) on cardiac and hemodynamic functions in children with ARDS.
Patients and Methods: Twenty children aged 1-14 years fulfilling ARDS criteria were included. The following parameters were recorded after ventilating the patients on PCV and APRV: ventilation parameters [peak inspiratory pressure (PIP) and mean airway pressure (MAP)], oxygenation parameters PaO2/FiO2 ratio and oxygen delivery, hemodynamic parameters and urine output.
Results: PIP significantly decreased from 29±7 with PCV to 24±4 cmH2O with APRV, while MAP was significantly higher during APRV(17±5) than during PCV (13±3(cmH2O. PaO2/FiO2 ratio increased significantly from 265±25 during PCV to 295±33 during APRV. Oxygen delivery increased significantly from 865±98 during PCV to 1196±127 ml/min during APRV. Cardiac index increased significantly from 3.2±0.2 during PCV to 4.1±0.3 l/min/m2 during APRV. Urine output increased significantly from 0.78±0.1 during PCV to 0.97±0.2 ml/kg/h during APRV. The use of sedatives and inotropics were decreased significantly during APRV compared to PCV.
Conclusions: APRV may be a suitable mode for ventilating ARDS patients providing better lung recruitment and oxygenation, avoiding more lung injury and cardiac compromise compared with pressure control ventilation.
- © 2012 ERS