Abstract
Mechanical ventilation is one of the most common interventions used in the intensive care unit (ICU); it is a life-saving procedure and a cornerstone in supporting a wide variety of patients from those going through elective surgery procedures to patients with life-threatening processes such as severe sepsis or acute respiratory distress syndrome (ARDS) [1]. Initially conceived as supportive treatment for patients with complications of poliomyelitis but without parenchymal lung disease, positive-pressure mechanical ventilation has evolved over the years due to our expanding knowledge of respiratory physiology, and to advances in ventilator design which allow faster responses to the requirements of each patient.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Esteban A, Anzueto A, Frutos F, et al (2002) Characteristics and outcomes in adult patients receiving mechanical ventilation. A 28-day international study. JAMA 287:345–355
Haitsma JJ (2007) Physiology of mechanical ventilation. Crit Care Clin 23:117–134
Pinhu L, Whitehead T, Evans T, Griffiths M (2003) Ventilator-associated lung injury. Lancet 361:332–340
Tremblay LN, Slutsky AS (2006) Ventilator-induced lung injury: from the bench to the bedside. Intensive Care Med 32:24–33
Webb HH, Tierney DF (1974) Experimental pulmonary edema due to intermittent positive pressure ventilation with high inflation pressures. Protection by positive end-expiratory pressure. Am Rev Respir Dis 110:556–565
Dreyfuss D, Soler P, Basset G, Saumon G (1988) High inflation pressure pulmonary edema. Respective effects of high airway pressure, high tidal volume, and positive end-expiratory pressure. Am Rev Respir Dis 137:1159–1164
Dreyfuss D, Saumon G (1998) Ventilator-induced lung injury: Lessons from experimental studies. Am J Respir Crit Care Med 157:294–323
Katzenstein AL, Bloor CM, Leibow AA (1976) Diffuse alveolar damage — the role of oxygen, shock, and related factors. A review. Am J Pathol 85:209–228
Ranieri VM, Suter PM, Tortorella C, et al (1999) Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial. JAMA 282:54–61
Weg JG, Anzueto A, Balk RA, et al (1998) The relation of pneumothorax and other air leaks to mortality in the acute respiratory distress syndrome. N Engl J Med 338:341–346
Tremblay L, Valenza F, Ribeiro SP, Li J, Slutsky AS (1997) Injurious ventilatory strategies increase cytokines and c-fos m-RNA expression in an isolated rat lung model. J Clin Invest 99:944–952
Slutsky AS (1999) Lung injury caused by mechanical ventilation. Chest 116:9S–15S
Tremblay LN, Slutsky AS (1998) Ventilation-induced lung injury: from barotrauma to biotrauma. Proc Assoc Am Phys 110:482–488
Schultz MJ, Haitsma JJ, Slutsky AS, Gajic O (2007) What tidal volumes should be used in patients without acute lung injury? Anesthesiology 106:1226–1231
Frank J, Matthay M (2003) Science review: Mechanisms of ventilator-induced injury. Crit Care 7:233–241
Held HD, Boettcher S, Hamann L, Uhlig S (2001) Ventilation-induced chemokine and cytokine release is associated with activation of nuclear factor-kappaB and is blocked by steroids. Am J Respir Crit Care Med 163:711–716
Nieman G (2006) Can ventilator mode reduce ventilator-induced lung injury? Crit Care Med 34:565–566
Marini J, Hotchkiss J, Broccard A (2003) Bench-to-bedside review: Microvascular and airspace linkage in ventilator-induced lung injury. Crit Care 7:435–444
Imai Y, Parodo J, Kajikawa O, et al (2003) Injurious mechanical ventilation and end-organ epithelial cell apoptosis and organ dysfunction in an experimental model of acute respiratory distress syndrome. JAMA 289:2104–2112
Gattinoni L, Pesenti A (2005) The concept of “baby lung”. Intensive Care Med 31:776–784
The Acute Respiratory Distress Syndrome Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342:1301–1308
Borges JB, Okamoto VN, Matos GFJ, et al (2006) Reversibility of lung collapse and hypoxemia in early acute respiratory distress syndrome. Am J Respir Crit Care Med 174:268–278
Amato MB, Barbas CS, Medeiros DM, et al (1998) Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 338:347–354
Rubenfeld GD, Caldwell E, Peabody E, et al (2005) Incidence and outcomes of acute lung injury. N Engl J Med 353:1685–1693
Ware LB, Matthay MA (2000) The acute respiratory distress syndrome. N Engl J Med 342: 1334–1349
Vincent JL, Zambon M (2006) Why do patients who have acute lung injury/acute respiratory distress syndrome die from multiple organ dysfunction syndrome? Implications for management. Clin Chest Med 27:725–731
Bernard GR, Artigas A, Brigham KL, et al (1994) The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 149:818–824
Villar J, Kacmarek RM, Perez-Mendez L, Aguirre-Jaime A (2006) A high positive end-expiratory pressure, low tidal volume ventilatory strategy improves outcome in persistent acute respiratory distress syndrome: a randomized, controlled trial. Crit Care Med 34:1311–1318
The National Heart Lung and Blood Institute ARDS Clinical Trials Network (2004) Mechanical ventilation with higher versus lower positive end-expiratory pressures in patients with acute lung injury and the acute respiratory distress syndrome. N Engl J Med 351:327–336
Stock MC, Downs JB, Frolicher DA, Stock MC, Downs JB, Frolicher DA (1987) Airway pressure release ventilation. Crit Care Med 15:462–466
Habashi NMM (2005) Other approaches to open-lung ventilation: Airway pressure release ventilation. Crit Care Med 33(suppl 3):S228–240
Rose L (2006) Advanced modes of mechanical ventilation: Implications for practice. AACN Adv Crit Care 17:145–158
Putensen C, Muders T, Varelmann D, Wrigge H (2006) The impact of spontaneous breathing during mechanical ventilation. Curr Opin Crit Care 12:13–18
Putensen C, Zech S, Wrigge H, et al (2001) Long-term effects of spontaneous breathing during ventilatory support in patients with acute lung injury. Am J Respir Crit Care Med 164:43–49
Putensen C, Wrigge H (2004) Clinical review: biphasic positive airway pressure and airway pressure release ventilation. Crit Care 8:492–497
Varpula T (2004) Airway pressure release ventilation as a primary ventilatory mode in acute respiratory distress syndrome. Acta Anaesthesiol Scand 48:722–731
Varpula T, Jousela I, Niemi R, Takkunen O, Pettila V (2003) Combined effects of prone positioning and airway pressure release ventilation on gas exchange in patients with acute lung injury. Acta Anaesthesiol Scand 47:516–524
Fan E, Mullaly A, Ko M, et al (2007) Airway pressure release ventilation in acute lung injury/ acute respiratory distress syndrome patients. Crit Care 11:180
Kaplan LJ, Bailey H, Formosa V (2001) Airway pressure release ventilation increases cardiac performance in patients with acute lung injury/adult respiratory distress syndrome. Crit Care 5:221–226
Neumann P, Hedenstierna G (2001) Ventilatory support by continuous positive airway pressure breathing improves gas exchange as compared with partial ventilatory support with airway pressure release ventilation. Anesth Analg 92:950–958
Frawley PM (2001) Airway pressure release ventilation: theory and practice. AACN Clin Issues 12:234–246
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer Science + Business Media Inc.
About this paper
Cite this paper
Gutiérrez Mejía, J., Fan, E., Ferguson, N.D. (2008). Airway Pressure Release Ventilation: Promises and Potentials for Concern. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-77383-4_28
Download citation
DOI: https://doi.org/10.1007/978-0-387-77383-4_28
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-77382-7
Online ISBN: 978-0-387-77383-4
eBook Packages: MedicineMedicine (R0)