Effects of airway pressure release ventilation on lung physiology assessed by electrical impedance tomography in patients with early moderate-to-severe ARDS - Critical Care

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Effects of airway pressure release ventilation on lung physiology assessed by electrical impedance tomography in patients with early moderate-to-severe ARDS - Critical Care
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A paper in Crit_Care states that airway pressure release ventilation provides lung recruitment, stabilization, and homogeneity, potentially protecting injured lungs in patients with early moderate-to-severe acute respiratory distress syndrome.

can be increased by 2 cmHdoes not improve or remains below 150 mmHg, prone positioning will be considered. If refractory hypoxemia persists, recruitment maneuver and extracorporeal membrane oxygenation will be considered.

EIT assessment was administered shortly after APRV , and 6 h , 12 h , and 24 h after APRV initiation. Parameters of ventilator, respiratory mechanics, and hemodynamics were also recorded at T0, T1, T2, and T3 before EIT assessment. Arterial blood gases analysis was recorded at T0 and T3.The primary endpoint of the study was regional tidal volume distribution after 24 h of APRV.

Data from EIT-based measurements showed that the regional lung ventilation and perfusion significantly redistributed from the ventral to dorsal region following ARPV application . The median GI index of ventilation progressively decreased [0.61 to 0.50 ,< 0.001], and CoV gradually changed towards dorsal regions . Patients trend to have an increased global V/Q matching and decreased shunt-EIT from T0 to T3, but not significantly; however, the dorsal V/Q matching increased significantly (25.

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