• Neurocritical care · Oct 2012

    Case Reports

    The effect of APRV ventilation on ICP and cerebral hemodynamics.

    • Paul E Marik, Alisha Young, Steve Sibole, and Alex Levitov.
    • Division of Pulmonary and Critical Care Medicine, Department of Respiratory Services, Eastern Virginia Medical School, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507, USA. marikpe@evms.edu
    • Neurocrit Care. 2012 Oct 1;17(2):219-23.

    BackgroundAirway pressure release ventilation (APRV) is an alternative approach to the low-tidal volume "open-lung" ventilation strategy. APRV is associated with a higher mean airway pressure than conventional ventilation and has therefore not been evaluated in patients with acute neurological injuries.MethodsCase report.ResultsWe report a patient with severe progressive hypoxemia following a subarachnoid hemorrhage who was converted from pressure-controlled mechanical ventilation to APRV. This change in ventilatory mode was associated with a significant improvement in oxygenation and alveolar ventilation with an associated increase in cerebral blood flow and a negligible increase in intracranial pressure.ConclusionAPRV may safely be applied to neurocritically ill patients, and that this mode of ventilation may increase cerebral blood flow without increasing intracranial pressure.

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