• Nader M Habashi.
• Multi-trauma ICU, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
• Crit. Care Med. 2005 Mar 1;33(3 Suppl):S228-40.

ObjectiveTo review the use of airway pressure release ventilation (APRV) in the treatment of acute lung injury/acute respiratory distress syndrome.Data SourcePublished animal studies, human studies, and review articles of APRV.Data SummaryAPRV 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.ConclusionAPRV 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.

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