Respiratory failure & ventilation
Effects of airway pressure release ventilation on lung physiology assessed by electrical impedance tomography in patients with early moderate-to-severe acute respiratory distress syndrome (ARDS)
Authors' conclusion
APRV optimizes the distribution of ventilation and perfusion, reducing lung heterogeneity, which potentially reduces the risk of ventilator-induced lung injury.
Study context
- Population
- Adults with early moderate-to-severe ARDS mechanically ventilated with airway pressure release ventilation (APRV)
- Participants
- 12 adults
- Exposure
- APRV: Electrical impedance tomography (EIT) measures at T0 vs 6 h, 12 h and 24 h after initiation
- Outcome
- Ventilation and perfusion distribution by EIT
- Follow-up
- T0 to T3 (24 h)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Global inhomogeneity index decreased, median (IQR) 0.61 (0.55-0.62) to 0.50 (0.42-0.53)
- p < 0.001
- Center of ventilation shifted dorsally, 43.31 ± 5.07 to 46.84 ± 4.96%
- p = 0.048
- Dorsal ventilation/perfusion matching increased T0 to T3, 25.72 ± 9.01 to 29.80 ± 7.19%
- p = 0.007
Observational data: associations, not effects.
Further findings
Correlation of dorsal ventilation (%) with gas exchange
- Correlation with PaO2/FiO2, r
- 0.624
- Correlation with PaCO2, r
- −0.408
- PaO2/FiO2 p = 0.001; PaCO2 p = 0.048
Original publication
Effects of airway pressure release ventilation on lung physiology assessed by electrical impedance tomography in patients with early moderate-to-severe ARDS. Crit Care. Published 8 May 2023. doi:10.
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