Airway pressure release ventilation in newborns

Abstract

Airway pressure release ventilation is a mechanical ventilation method that uses a controlled positive airway pressure in order to maximize alveolar recruitment, with prolonged inspiratory times, therefore allowing spontaneous breathing during both phases of the respiratory cycle. The authors describe their experience in twelve cases of newborn patients with acute respiratory failure treated with airway pressure release ventilation when oxygenation did not improve with pressure control ventilation. The mean age of patients was 13 ± 16.5 days. The fractional concentration of oxygen (FiO2) decreased from 62.9 ± 23.6 cmH2O for pressure control ventilation to 44 ± 14.0 cmH2O for airway pressure release ventilation. The mean partial arterial oxygen pressure increased from 54.6 ± 11.9 mmHg to 92 ± 32 mmHg. The mean partial carbon dioxide pressure decreased from 53.2 ± 15.6 mmHg to 43.1 ± 10 mmHg and the peak inspiratory pressure fell from 16.8 ± 5.9 cm H2O to 16.6 ± 5.3, respectively.Airway pressure release ventilation may improve oxygenation in pediatric patients with acute respiratory failure when conventional mechanical ventilation fails.