Airway Pressure Release Ventilation (APRV) | Mechanical Ventilation | Little Criticos

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In this series we discuss Airway Pressure Release Ventilation (APRV).
In part 8 of this series, we discuss the various Airway Pressure Release Ventilation (APRV). It is known by different names as BiVent, BiLevel, DuoPAP. This mode is predominantly used in moderate to severe ARDS when oxygenation is defective. We discuss the mechanism, variables, initial setting and benefits of APRV in this discussion. It is important to understand these as they help us in identifying problems and troubleshooting ventilation.
Airway Pressure Release Ventilation (APRV) | Mechanical Ventilation | Little Criticos :
#APRV
#BiVent
#Bilevel
Disclaimer:
This video provides general information about mechanical ventilation. Patient needs and clinical care settings vary, and the information provided is not intended as medical, diagnostic or treatment advice. Ventilators should be used under the supervision of a qualified licensed medical professional. Consult the manufacturer’s instructions for the particular device you are using and the product information sheet for any drug administered. This subject is complex and evolving. The authors and providers of these videos do not warrant that the information provided is accurate in every respect or complete, and disclaim responsibility for your use and application of the information.

[@gouthamupadhya5336]

Great content! Thank you!

[@ajaiarora4711]

Excellent presentation 👌👌👌thanks ! 🙏🏻

[@LittleCriticos]

Thankyou. Keep watching

[@AliRehman-c2g]

Excellently Explained.well done ..keep it up.

[@LittleCriticos]

Thanks for the kind comments.

[@pratapupadhya.6476]

Grt man

[@LittleCriticos]

Thankyou. Keep watching

[@dsrahul9511]

Thank you, 25 percent of PEFR can you give example for this

[@LittleCriticos]

Thank you Rahul.
We do not want expiratory flow to reach baseline as this will cause alveolar collapse and hamper ventilation. We can adjust T low by looking at the PEFR. Usually keeping a Tlow at 25-50% of PEFR can solve this issue. Depending on the lung condition restrictive vs obstructive we can decide on Tlow needed.
Keep watching and sharing with your friends as well.

[@ahmet-vm2qt]

​@@LittleCriticosexpiratory pause will direct you to arrange the time

[@bhushitgadhiya5128]

Does people use aprv mode in pediatric patients?

[@LittleCriticos]

Thank you for the question Bhushit. Evidence is still evolving. Currently, there is only one pediatric RCT which was stopped at interim phase as APRV showed higher mortality when compared to conventional ventilation.
However, a larger adult trial did show significant mortality and morbidity benefits. Having said this, these trials have their limitations and difference in the settings employed. As understanding of this mode is still evolving, this can be used on an individual basis especially in severe ARDS settings where Hfov or Ecmo support are not available.
Whether early use will be beneficial needs to be tested in future trials!