Airway Pressure Release Ventilation
Traditionally mechanical ventilatory support has relied on increasing airway pressure above ambient to inflate the lungs. Mechanical inflation of the lungs with positive pressure causes fundamental alterations in cardiopulmonary mechanics which frequently lead to pulmonary and circulatory complications (1). Moreover, high airway and intrathoracic pressure during positive pressure breaths may not allow use of adequate continuous positive airway pressure (CPAP) to restore expiratory lung volume and, consequently, prevents optimization of lung mechanics and gas exchange (2, 3). Even when the ventilator is adjusted carefully, positive pressure ventilation will elevate mean intrathoracic pressure and result in cardiovascular compromise in patients with normal or low intravascular volume. Periodic alveolar overinflation may cause structural lung injury, or may impair healing of the already injured lung.
KeywordsContinuous Positive Airway Pressure Acute Lung Injury Airway Pressure Positive Pressure Ventilation Pressure Support Ventilation
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- 12.Smith D, Leon M, Mann M, Rubin M (1991) Does airway pressure release ventilation alter lung function during acute lung injury? Crit Care Med 19:S51Google Scholar