Division of Pulmonary and Critical Care Medicine, Department of Respiratory Services, Eastern Virginia Medical School, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507, USA.
Neurocrit Care. 2012 Oct;17(2):219-23. doi: 10.1007/s12028-012-9739-4.
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.
Case report.
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.
APRV may safely be applied to neurocritically ill patients, and that this mode of ventilation may increase cerebral blood flow without increasing intracranial pressure.
气道压力释放通气（APRV）是一种替代低潮气量“开放肺”通气策略的方法。APRV 的平均气道压力高于常规通气，因此尚未在急性神经损伤患者中进行评估。
病例报告。
我们报告了一例蛛网膜下腔出血后严重进行性低氧血症的患者，该患者从压力控制机械通气转为 APRV。通气模式的这种改变与氧合和肺泡通气的显著改善相关，同时伴有脑血流的增加和颅内压的轻微增加。
APRV 可安全应用于神经危重症患者，并且这种通气模式可以增加脑血流而不增加颅内压。
