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Clin Respir J. 2015 Oct;9(4):423-9. doi: 10.1111/crj.12155. Epub 2014 May 19.

Hemodynamic changes in child acute respiratory distress syndrome with airway pressure release ventilation: a case series.

Author information

1
Department of Pediatrics, Pediatric Critical Care Medicine, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.
2
School of Public Health, University of Alberta, Edmonton, Canada.
3
Division of Pediatric Critical Care, Pediatric Intensive Care Unit, Shizuoka Children's Hospital, Shizuoka, Japan.

Abstract

BACKGROUND:

Airway pressure release ventilation (APRV) is widely used in adult critical care settings. However, information on the use of APRV in the pediatric population is limited.

METHODS:

All patients admitted to the medical-surgical pediatric intensive care unit with a diagnosis of acute respiratory distress syndrome (ARDS) who received APRV for at least 12 h between 2007 and 2009 were reviewed.

RESULTS:

Thirteen patients with a variety of etiologies of ARDS were included, with a mean weight of 18.2 ± 15.0 kg, a mean age of 68 ± 57 months and a predicted mortality (based on Pediatric Index of Mortality version 2) of 23.9 ± 13.8%. Patients were placed on APRV for a median of 4 days (range 1-10 days). There was no change in blood gas parameters after 1 h or 12 h of APRV when compared with pre-APRV. There was no statistical difference in hemodynamic parameters, including mean arterial blood pressure, central venous blood pressure and heart rate, while the patients were on APRV.

CONCLUSION:

APRV could be safely used in pediatric ARDS patients, without significant hemodynamic compromise or side effects.

KEYWORDS:

acute respiratory distress syndrome; airway pressure release ventilation; children; spontaneous breathing

PMID:
24761938
DOI:
10.1111/crj.12155
[Indexed for MEDLINE]
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