OBJECTIVE: To evaluate the effects of airway pressure release ventilation (APRV) and continuous positive airway pressure (CPAP) on hemodynamics, lung mechanics and oxygen metabolism index. METHODS:Fifteen ARDS cases ventilated and monitored by the pulse contour method (PiCCO) were randomized into APRV group and CPAP group, then lung recruitment maneuver (RM) was executed every 4 hours. In APRV group, Phigh was 35 cm H(2)O (1 cm H(2)O=0.098 kPa) and Plow was set at lower inflection point (LIP) of the static pressure-volume (P-V) curve. In CPAP group, CPAP was also 35 cm H(2)O. The duration of RM in both groups was 40 seconds. Before and after RM the parameters of lung mechanics, oxygen metabolism index and hemodynamics were monitored and compared. RESULTS: (1) In APRV group cardiac index (CI) was decreased slightly during RM with shorter duration than CPAP group. (2) The parameters of lung mechanics and oxygenation were improved significantly in both groups, and they were better in APRV group than CPAP group. CONCLUSION: In APRV group sedation can be abstained during RM, and the hemodynamics were hardly disturbed. Improvement of lung mechanics and oxygenation is much better with APRV than CPAP mode.
RCT Entities:
OBJECTIVE: To evaluate the effects of airway pressure release ventilation (APRV) and continuous positive airway pressure (CPAP) on hemodynamics, lung mechanics and oxygen metabolism index. METHODS: Fifteen ARDS cases ventilated and monitored by the pulse contour method (PiCCO) were randomized into APRV group and CPAP group, then lung recruitment maneuver (RM) was executed every 4 hours. In APRV group, Phigh was 35 cm H(2)O (1 cm H(2)O=0.098 kPa) and Plow was set at lower inflection point (LIP) of the static pressure-volume (P-V) curve. In CPAP group, CPAP was also 35 cm H(2)O. The duration of RM in both groups was 40 seconds. Before and after RM the parameters of lung mechanics, oxygen metabolism index and hemodynamics were monitored and compared. RESULTS: (1) In APRV group cardiac index (CI) was decreased slightly during RM with shorter duration than CPAP group. (2) The parameters of lung mechanics and oxygenation were improved significantly in both groups, and they were better in APRV group than CPAP group. CONCLUSION: In APRV group sedation can be abstained during RM, and the hemodynamics were hardly disturbed. Improvement of lung mechanics and oxygenation is much better with APRV than CPAP mode.