Airway Pressure Release Ventilation as a Rescue Therapy in Pediatric Acute Respiratory Distress Syndrome

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Yener N., Udurgucu M.

INDIAN JOURNAL OF PEDIATRICS, cilt.87, sa.11, ss.905-909, 2020 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 87 Sayı: 11
  • Basım Tarihi: 2020
  • Doi Numarası: 10.1007/s12098-020-03235-w
  • Dergi Adı: INDIAN JOURNAL OF PEDIATRICS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, PASCAL, BIOSIS, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.905-909
  • Anahtar Kelimeler: Pediatric acute respiratory distress syndrome, Airway pressure release ventilation, Mechanical ventilation, FREQUENCY OSCILLATORY VENTILATION, LUNG INJURY, MECHANICAL VENTILATION, MODE
  • Ondokuz Mayıs Üniversitesi Adresli: Evet

Özet

Objectives To describe experience with airway pressure release ventilation (APRV) in children with severe acute respiratory distress syndrome (ARDS) refractory to conventional low tidal volume ventilation. Methods This retrospective observational study was performed in an 11-bed, level 3 pediatric intensive care unit. Evaluation was made of 30 pediatric patients receiving airway pressure release ventilation as rescue therapy for severe ARDS. Results Patients were switched to APRV on an average 3.2 +/- 2.6 d following intubation. When changed from conventional mechanical ventilation (CMV) to APRV, there was an expected increase in the SpO(2)/FiO(2) ratio (165.1 +/- 13.6 vs. 131.7 +/- 10.2; p = 0.035). Mean peak inspiratory pressure was significantly lower during APRV (25.4 +/- 1.26 vs. 29.8 +/- 0.60, p < 0.001) compared to CMV prior to APRV but mean airway pressure (P-aw) was significantly higher during APRV (19.1 +/- 0.9 vs. 15.3 +/- 1.3, p < 0.001). Hospital mortality in this study group was 16.6%. Conclusions The results of this study support the hypothesis that APRV may offer potential clinical advantages for ventilatory management and may be considered as an alternative rescue mechanical ventilation mode in pediatric ARDS patients refractory to conventional ventilation.