scholarly journals Airway pressure release ventilation in mechanically ventilated patients with COVID-19: a multicenter observational study

2021 ◽  
Author(s):  
John S. Zorbas ◽  
Kwok M. Ho ◽  
Edward Litton ◽  
Bradley Wibrow ◽  
Edward Fysh ◽  
...  
Keyword(s):  
Observational Study ◽  
Airway Pressure ◽  
Airway Pressure Release Ventilation ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Multicenter Observational Study ◽  
Pressure Release ◽  
Pressure Release Ventilation ◽  
Ventilated Patients

scholarly journals Implementation and feasibility of inverse-ratio Airway Pressure Release Ventilation (APRV): Switching from Conventional Ventilation to APRV in Two French ICUs.

2020 ◽  
Author(s):  
Matthieu Koszutski ◽  
Benjamin Pequignot ◽  
Antoine Kimmoun ◽  
Thomas Remen ◽  
Philippe Guerci ◽  
...  
Keyword(s):  
Airway Pressure ◽  
Pressure Support ◽  
Airway Pressure Release Ventilation ◽  
Conventional Ventilation ◽  
University Teaching ◽  
Volume Control ◽  
Mechanically Ventilated ◽  
Pressure Release ◽  
Ventilation Technique ◽  
Pressure Release Ventilation

Abstract Background:To evaluate the switching of patients mechanically ventilated on Pressure Support or Volume Control to inverse-ratio Airway Pressure Release Ventilation (APRV) during the COVID-19 pandemic.Methods:We performed a single-center retrospective observational analysis in two ICUs in a tertiary referral university teaching hospital in France. Were included patients with Covid-19 pneumonia requiring invasive ventilation with a PaO2:FiO2 ratio lower than 200 mmHg who performed a 6-hour trial of inverse-ratio APRV.Results:Seventeen consecutive patients who completed a 6-hour APRV trial in April 2020 were included. Three patients who were unable to be maintained on APRV due to an immediate fall in SpO2 were not included. In 12/17 patients (71%), the increase in PaO2:FiO2 ratio was greater than 20%. Mean (± standard deviation) PaO2:FiO2 ratio increased from 126 (± 28) mmHg to 178 (± 53) mmHg after 6 hours of APRV (p<0.001). Two patients presented a decrease in PaO2:FiO2 ratio after 6 hours of APRV. There was no appearance of significant hemodynamic impairment during APRV and an eventual increase in PaCO2 during the first hour of APRV was managed by increasing the respiratory rate (i.e. shortening T-high) and/or increasing tidal volume (i.e. increasing T-low).Conclusions:Switching from Conventional Ventilation (Pressure Support or Volume Assist Control) to inverse-ratio APRV for a 6-hour period in two ICUs that were not previously familiar with this ventilation technique was well tolerated, and associated with a marked improvement in oxygenation. Further studies evaluating inverse-ratio APRV in acute respiratory failure are warranted.Trial registration:NCT04386369

scholarly journals AIRWAY PRESSURE RELEASE VENTILATION USE IN COVID-19 ARDS: A SINGLE CENTER OBSERVATIONAL STUDY

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A1089-A1090
Author(s):  
Swaminathan Perinkulam Sathyanarayanan ◽  
Khizar Hamid ◽  
Muhammad Hamza ◽  
Fady Jamous
Keyword(s):  
Observational Study ◽  
Airway Pressure ◽  
Airway Pressure Release Ventilation ◽  
Single Center ◽  
Pressure Release ◽  
Pressure Release Ventilation ◽  
Single Center Observational Study

HIGH FREQUENCY PERCUSSIVE VENTILATION CAN MIMIC AIRWAY PRESSURE RELEASE VENTILATION IN A TEST LUNG MODEL

2004 ◽  
Vol 32 (Supplement) ◽  
pp. A38
Author(s):  
Faera L Byerly ◽  
Bruce A Cairns ◽  
Kathy A Short ◽  
John A Haithcock ◽  
Lynn Shapiro ◽  
...  
Keyword(s):  
High Frequency ◽  
Airway Pressure ◽  
Airway Pressure Release Ventilation ◽  
Lung Model ◽  
Test Lung ◽  
Pressure Release ◽  
Pressure Release Ventilation

scholarly journals Utilization of Airway Pressure Release Ventilation as a Rescue Strategy in COVID-19 Patients: A Retrospective Analysis

2021 ◽  
pp. 088506662110308
Author(s):  
Omar Mahmoud ◽  
Deep Patadia ◽  
James Salonia
Keyword(s):  
Retrospective Analysis ◽  
Airway Pressure ◽  
Minute Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Airway Pressure Release Ventilation ◽  
Inspiratory Time ◽  
Predicted Body Weight ◽  
Pressure Release ◽  
Refractory Hypoxemia ◽  
Pressure Release Ventilation

Background: Airway Pressure Release Ventilation (APRV) is a pressure controlled intermittent mandatory mode of ventilation characterized by prolonged inspiratory time and high mean airway pressure. Several studies have demonstrated that APRV can improve oxygenation and lung recruitment in patients with Acute Respiratory Distress Syndrome (ARDS). Although most patients with COVID-19 meet the Berlin criteria for ARDS, hypoxic respiratory failure due to COVID-19 may differ from traditional ARDS as patients often present with severe, refractory hypoxemia and significant variation in respiratory system compliance. To date, no studies investigating APRV in this patient population have been published. The aim of this study was to evaluate the effectiveness of APRV as a rescue mode of ventilation in critically ill patients diagnosed with COVID-19 and refractory hypoxemia. Methods: We conducted a retrospective analysis of patients admitted with COVID-19 requiring invasive mechanical ventilation who were treated with a trial of APRV for refractory hypoxemia. PaO2/FIO2 (P/F ratio), ventilatory ratio and ventilation outputs before and during APRV were compared. Results: APRV significantly improved the P/F ratio and decreased FIO2 requirements. PaCO2 and ventilatory ratio were also improved. There was an increase in tidal volume per predicted body weight during APRV and a decrease in total minute ventilation. On multivariate analysis, higher inspiratory to expiratory ratio (I: E) and airway pressure were associated with greater improvement in P/F ratio. Conclusions: APRV may improve oxygenation, alveolar ventilation and CO2 clearance in patients with COVID-19 and refractory hypoxemia. These effects are more pronounced with higher airway pressure and inspiratory time.

Lung Transplant Outcomes in Donors Managed with Airway Pressure Release Ventilation

2017 ◽  
Vol 36 (4) ◽  
pp. S318-S319
Author(s):  
S. Biswas Roy ◽  
C. Haworth ◽  
M. Olson ◽  
P. Kang ◽  
K.E. Varsch ◽  
...  
Keyword(s):  
Airway Pressure ◽  
Lung Transplant ◽  
Airway Pressure Release Ventilation ◽  
Transplant Outcomes ◽  
Pressure Release ◽  
Pressure Release Ventilation
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