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Editorial
. 2018 Apr;10(Suppl 9):S1058-S1063.
doi: 10.21037/jtd.2018.03.156.

APRV for ARDS: The Complexities of a Mode and How It Affects Even the Best Trials

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Free PMC article
Editorial

APRV for ARDS: The Complexities of a Mode and How It Affects Even the Best Trials

Eduardo Mireles-Cabodevila et al. J Thorac Dis. .
Free PMC article

Conflict of interest statement

Conflicts of Interest: Eduardo Mireles-Cabodevila and Siddharth Dugar have no conflicts of interest to declare. Robert L. Chatburn is a consultant for IngMar Medical and Drive Medical.

Figures

Figure 1
Figure 1
Spontaneous breaths superimposed on a mandatory breath during BiLevel mode with a PB 840 ventilator. When Thigh cycles off in synchrony with a spontaneous exhalation, actual Tlow becomes longer than set Tlow resulting in lower end expiratory lung volume and pressure. Patm, atmospheric pressure; TEF, terminal expiratory flow; PEF, peak expiratory flow.
Figure 2
Figure 2
The supplemental material of the paper by Zhou et al. shows exactly this result as well (screen shot from supplemental material labeled as Figure S1 Case One). This screen shot of the PB 840 in BiLevel mode with ARPV settings shows the first breath has a Tlow set at 0.41 s, as indicated in the figure legend. However, the flow waveform for the second breath shows that due to synchrony of mandatory breath cycling with a spontaneous breath exhalation, the Tlow is considerably longer.

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