Airway pressure release ventilation

Airway pressure release ventilation (APRV) arrived with much hope of a novel strategy to minimize lung injury with its ‘open lung’ concept.

This systematic review and meta-analysis surveyed the literature. They found a higher number of ventilator-free days at 28 day and a lower hospital mortality in acute hypoxemic patients treated with APRV than conventional ventilation, without any negative hemodynamic impact or higher risk of barotrauma.

They caution however that the evidence is low quality with some heterogeneity and further randomized trials are needed before APRV can be recommended as superior to conventional strategies.

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