Airway Pressure Release Ventilation (APRV)

APRV - Airway Pressure Release Ventilation

  • The key feature is, TWO LEVELS OF PEEP.

    This mode can have pressure support added, or automatic tube compensation.

     Expiration occurs during the low-PEEP time.

     The Low PEEP time (show above to be equal to the high PEEP time) should NEVER be that long;  it should be kept as low as possible to prevent de-recruitment.

     The patient draws breath at two different lung volumes, set by the two different pressure levels.  At the high peep, the lungs are almost completely full, and the patient is breathing near vital capacity.

    This mode of ventilation is usually reserved for severe ARDS.  It is controversial; many believe it is of no use.

References

Most of this information comes from only two textbooks. With "Basic Assessment and Support in Intensive Care" by Gomersall et al (as well as whatever I picked up during the BASIC course) as a foundation, I built using the humongous and canonical "Principles and Practice of Mechanical Ventilation" by Tobins et al – the 1442 page 2nd edition.