• A&A practice · Jun 2020

    Case Reports

    Airway Pressure Release Ventilation Combined With Prone Positioning in Acute Respiratory Distress Syndrome: Old Tricks New Synergy: A Case Series.

    • Si Jia Lee, Yilin Lee, Andrew Kong, and Shin Yi Ng.
    • From Department of Surgical Intensive Care, SingHealth, Singapore.
    • A A Pract. 2020 Jun 1; 14 (8): e01231.

    AbstractAirway pressure release ventilation (APRV) shares several overlapping mechanisms with prone positioning in improving ventilation-perfusion mismatch in patients with acute respiratory distress syndrome (ARDS). However, the combination of APRV and prone positioning is seldom performed because assist/controlled ventilation remains the mainstay ventilatory mode. We describe 5 cases of severe ARDS where APRV and prone positioning were applied. All patients' partial pressure of arterial oxygen (PaO2):inspired oxygen concentration (FiO2) ratios improved after treatment, and 3 patients were extubated within 72 hours of turning supine. In our experience, APRV can be safely used in the prone position in a select subgroup of ARDS patients with resulting significant oxygenation improvement.

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