Airway Pressure Release Ventilation in a Patient with Acute Pulmonary Injury

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Airway pressure release ventilation is a recently described method of ventilatory support. It allows spontaneous ventilation with CPAP but differs from conventional ventilatory modes because, with APRV, peak inflation pressure never exceeds the level of CPAP, and airway pressure decreases, rather than increases, when tidal volume is delivered. The risk of pulmonary barotrauma and adverse hemodynamic effects associated with conventional modes of positive-pressure mechanical ventilation may be decreased because of lower peak inflation and mean airway pressures. We describe a patient in whom several risk factors for these complications were present who was treated successfully with APRV.