Airway Pressure Release Ventilation Benefits in a Patient with Chronic Lymphocytic Leukemia

Abstract

Background: Airway pressure release ventilation (APRV) is a novel mode of mechanical ventilation (MV) used in the treatment of acute respiratory distress syndrome (ARDS) for patients with severe hypoxemia with a strategy to prevent ventilator-induced lung injury (VILI). APRV can avert VILI because it can limit alveolar-distending pressures. This is a case report of a 45-year-old man diagnosed with chronic lymphocytic leukemia who later developed community-acquired pneumonia and ARDS. Methods: APRV was applied successfully. Initially, he was unsuccessfully managed on conventional ventilation using an “open-lung” ventilation strategy (high positive end-expiratory pressure, high respiratory rate, and low tidal volume), recruitment maneuvers, and prone positioning. Results: A change in the ventilation mode to APRV resulted in the reduction of extravascular lung water as indicated by a chest X-ray, improvement in the oxygenation indices, and successful liberation from the ventilator. Conclusion: This case report concluded that APRV is safe in patients diagnosed with ARDS if other “open-lung” MV approaches and prone positioning have failed.