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The Effect of APRV Ventilation on ICP and Cerebral Hemodynamics

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Abstract

Background

Airway 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.

Methods

Case report.

Results

We 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.

Conclusion

APRV 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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Author information

Authors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, Department of Respiratory Services, Eastern Virginia Medical School, 825 Fairfax Ave, Suite 410, Norfolk, VA, 23507, USA

    Paul E. Marik, Alisha Young & Alex Levitov

  2. Sentara Norfolk General Hospital, Norfolk, VA, 23507, USA

    Steve Sibole

Authors
  1. Paul E. Marik
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  2. Alisha Young
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  3. Steve Sibole
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  4. Alex Levitov
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Correspondence to Paul E. Marik.

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Marik, P.E., Young, A., Sibole, S. et al. The Effect of APRV Ventilation on ICP and Cerebral Hemodynamics. Neurocrit Care 17, 219–223 (2012). https://doi.org/10.1007/s12028-012-9739-4

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  • DOI: https://doi.org/10.1007/s12028-012-9739-4

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