Other approaches to open-lung ventilation: airway pressure release ventilation

Crit Care Med. 2005 Mar;33(3 Suppl):S228-40. doi: 10.1097/01.ccm.0000155920.11893.37.


Objective: To review the use of airway pressure release ventilation (APRV) in the treatment of acute lung injury/acute respiratory distress syndrome.

Data source: Published animal studies, human studies, and review articles of APRV.

Data summary: APRV has been successfully used in neonatal, pediatric, and adult forms of respiratory failure. Experimental and clinical use of APRV has been shown to facilitate spontaneous breathing and is associated with decreased peak airway pressures and improved oxygenation/ventilation when compared with conventional ventilation. Additionally, improvements in hemodynamic parameters, splanchnic perfusion, and reduced sedation/neuromuscular blocker requirements have been reported.

Conclusion: APRV may offer potential clinical advantages for ventilator management of acute lung injury/acute respiratory distress syndrome and may be considered as an alternative "open lung approach" to mechanical ventilation. Whether APRV reduces mortality or increases ventilator-free days compared with a conventional volume-cycled "lung protective" strategy will require future randomized, controlled trials.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Animals
  • Continuous Positive Airway Pressure*
  • Humans
  • Infant, Newborn
  • Respiratory Distress Syndrome / therapy*
  • Respiratory Distress Syndrome, Newborn / therapy