Airway Pressure Release Ventilation (APRV) is a mode of ventilation that allows spontaneous breathing throughout the ventilation cycle. It is a time-cycled mode of ventilation between two levels of positive airway pressure with the main time on the high level and a shorter period of time during the expiratory release to facilitate ventilation. This may not be a mode of ventilation many ED physicians are comfortable and have experience with and in this podcast Frank Lodeserto, MD reviews how to setup, titrate, and wean patients on this mode of ventilation.
Refractory Hypoxemia: Now maybe you have intubated a patient secondary to hypoxemic respiratory failure who is at high risk for the development of acute respiratory distress syndrome (ARDS). These patients, and really all patients, with exception of severe obstructive disease, I set up the ventilator to deliver 6mL/kg based on ideal body weight (not actual weight). Regardless if this is a pediatric or adult patient, I am setting up the ventilator to target 6 mL/kg of IBW. I can accomplish this with either pressure mode, where you set the pressure, but closely monitor the tidal volumes the patient is receiving....Read More