APRV

1. Potential Advantages Using Airway Pressure Release Ventilation Lewis J. Kaplan, MD, FACS, FCCM Associate Professor of Surgery Yale University School of Medicine Director, SICU & Surgical Critical Care Program

4. High CPAP Release (T low ) Phase cycle APRV: Pressure and Flow PEEP i T high

6. RUL COLLAPSE: Optimized PEEP, V T , Flow

7. APRV 1 HOUR

8. APRV 3 HOURS

9. WHAT APRV DOESN’T FIX RMSB

10. Which way do we go from here?

11. Spontaneous Breathing

13. Results: Experimental ALI torr cc % (Aeration Indexed to APRV +) * * * Adapted from: Wrigge H, et al. Anesthesiology 2003; 99(2):376-84

14. End Expiratory Lung Volume (N 2 ) Adapted from: Wrigge H, et al. Anesthesiology 2003; 99(2):376-84

16. Basilar Atelectasis

18. Summed Ventilation (ml/min) Sternum Spine

19. Summed Perfusion (ml/min) Sternum Spine

21. Hemodynamics

23. Etiology Of ALI/ARDS PNA Abd sepsis Trauma BSI TRALI TRALI = Transfusion Related Acute Lung Injury Percent Kaplan LJ, et al. Crit Care 2001; 5(4):221-6

24. Paw And Pharmacology Pawpk Paw % NMB % Sedatives pre post pre post pre post pre post # or % * * * Kaplan LJ, et al. Crit Care 2001; 5(4):221-6

25. C.I. % pre-DO 2 I LVSWI CVP pre post pre post pre post pre post Hemodynamics Pre and Post * * * Kaplan LJ, et al. Crit Care 2001; 5(4):221-6 # or %

28. APRV and Renal Blood Flow % cc Indexed Hering R, et al. Int Care Med 2002; 28(10):1426-33 * * * * * *

30. Comfort

33. APRV In The OR