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Editorial
. 2018 Apr;10(Suppl 9):S1058-S1063.
doi: 10.21037/jtd.2018.03.156.

APRV for ARDS: the complexities of a mode and how it affects even the best trials

Affiliations
Editorial

APRV for ARDS: the complexities of a mode and how it affects even the best trials

Eduardo Mireles-Cabodevila et al. J Thorac Dis. 2018 Apr.
No abstract available

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Conflict of interest statement

Conflicts of Interest: Eduardo Mireles-Cabodevila and Siddharth Dugar have no conflicts of interest to declare. Robert L. Chatburn is a consultant for IngMar Medical and Drive Medical.

Figures

Figure 1
Figure 1
Spontaneous breaths superimposed on a mandatory breath during BiLevel mode with a PB 840 ventilator. When Thigh cycles off in synchrony with a spontaneous exhalation, actual Tlow becomes longer than set Tlow resulting in lower end expiratory lung volume and pressure. Patm, atmospheric pressure; TEF, terminal expiratory flow; PEF, peak expiratory flow.
Figure 2
Figure 2
The supplemental material of the paper by Zhou et al. shows exactly this result as well (screen shot from supplemental material labeled as Figure S1 Case One). This screen shot of the PB 840 in BiLevel mode with ARPV settings shows the first breath has a Tlow set at 0.41 s, as indicated in the figure legend. However, the flow waveform for the second breath shows that due to synchrony of mandatory breath cycling with a spontaneous breath exhalation, the Tlow is considerably longer.

Comment on

References

    1. Jain SV, Kollisch-Singule M, Sadowitz B, et al. The 30-year evolution of airway pressure release ventilation (APRV). Intensive Care Med Exp 2016;4:11. 10.1186/s40635-016-0085-2 - DOI - PMC - PubMed
    1. Rose L, Hawkins M. Airway pressure release ventilation and biphasic positive airway pressure: a systematic review of definitional criteria. Intensive Care Med 2008;34:1766-73. 10.1007/s00134-008-1216-3 - DOI - PubMed
    1. Zhou Y, Jin X, Lv Y, et al. Early application of airway pressure release ventilation may reduce the duration of mechanical ventilation in acute respiratory distress syndrome. Intensive Care Med 2017;43:1648-59. 10.1007/s00134-017-4912-z - DOI - PMC - PubMed
    1. Brower RG, Matthay MA, Morris A, et al. 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 2000;342:1301-8. 10.1056/NEJM200005043421801 - DOI - PubMed
    1. Brower RG, Lanken PN, MacIntyre N, et al. Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. N Engl J Med 2004;351:327-36. 10.1056/NEJMoa032193 - DOI - PubMed

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