The effects of airway pressure release ventilation on respiratory mechanics in extrapulmonary lung injury

Kollisch-Singule, Michaela; Emr, Bryanna; Jain, Sumeet V.; Andrews, Penny; Satalin, Joshua; Liu, Jiao; Porcellio, Elizabeth; Kenyon, Van; Wang, Guirong; Marx, William; Gatto, Louis A.; Nieman, Gary F.; Habashi, Nader M.

doi:10.1186/s40635-015-0071-0

Intensive Care Medicine Experimental

Table 2 Pulmonary data in low tidal volume (LVt) versus airway pressure release ventilation (APRV)

From: The effects of airway pressure release ventilation on respiratory mechanics in extrapulmonary lung injury

		Baseline	12 h	24 h	36 h	48 h	p value
Plateau pressure (cmH₂O)	LVt	16.7 ± 2.7	14.5 ± 0.5	18.2 ± 1.1	22.0 ± 1.9	22.2 ± 2.0	0.0188§
Plateau pressure (cmH₂O)	APRV	18.2 ± 2.2	22.8 ± 2.5*	27.0 ± 0.6*	31.0 ± 0.6*	34.3 ± 0.9*	0.0188§
Transpulmonary pressure (cmH₂O)	LVt	12.7 ± 3.8	9.6 ± 1.7	11.2 ± 0.1	13.8 ± 1.7	14.9 ± 1.9	0.1116
Transpulmonary pressure (cmH₂O)	APRV	12.7 ± 3.2	12.6 ± 1.3	16.4 ± 1.5	14.6 ± 2.1	17.3 ± 2.9	0.1116
Pleural pressure (cmH₂O)	LVt	3.9 ± 1.3	4.9 ± 1.4	6.9 ± 1.1	8.2 ± 0.3	7.6 ± 0.5	<0.0001§
Pleural pressure (cmH₂O)	APRV	5.5 ± 1.0	10.2 ± 1.2*	10.6 ± 1.2	16.1 ± 1.4*	17.4 ± 3.5*	<0.0001§
End-expiratory pressure (set) (cmH₂O)	LVt	5.0 ± 0.0	5.0 ± 0.0	5.0 ± 0.0	6.0 ± 1.0	6.6 ± 1.7	<0.0001§
End-expiratory pressure (set) (cmH₂O)	APRV	0.0 ± 0.0*	0.0 ± 0.0*	0.0 ± 0.0*	0.0 ± 0.0*	0.0 ± 0.0*	<0.0001§
End-expiratory pressure (measured) (cmH₂O)	LVt	5.1 ± 0.1	5.0 ± 0.1	5.2 ± 0.1	6.2 ± 1.2	6.6 ± 1.7	<0.0001§
End-expiratory pressure (measured) (cmH₂O)	APRV	5.1 ± 0.1	10.7 ± 0.9*	11.8 ± 0.6*	14.2 ± 1.1*	17.8 ± 2.0*	<0.0001§
Tidal volume (cc kg⁻¹)	LVt	10.2 ± 0.1	6.0 ± 0.0	6.0 ± 0.0	5.9 ± 0.0	5.6 ± 0.3	<0.0001§
Tidal volume (cc kg⁻¹)	APRV	10.0 ± 0.1	9.7 ± 0.3*	11.0 ± 0.8*	12.3 ± 0.6*	13.3 0.6*	<0.0001§
Respiratory system elastance (cmH₂O L⁻¹)	LVt	31.2 ± 7.9	43.5 ± 4.2	59.8 ± 6.3	72.8 ± 8.3	76.4 ± 9.4	<0.0001§
Respiratory system elastance (cmH₂O L⁻¹)	APRV	35.8 ± 6.0	34.2 ± 4.8	38.5 ± 5.5	38.0 ± 5.6*	33.4 ± 4.6*	<0.0001§
Lung elastance (cmH₂O L⁻¹)	LVt	24.4 ± 9.4	29.3 ± 6.7	36.7 ± 1.6	45.7 ± 6.3	50.3 ± 8.3	<0.0001§
Lung elastance (cmH₂O L⁻¹)	APRV	29.7 ± 6.6	18.8 ± 2.6	23.8 ± 5.1	18.8 ± 4.8*	17.6 ± 5.1*	<0.0001§
Chest wall elastance (cmH₂O L⁻¹)	LVt	6.8 ± 1.9	14.2 ± 3.9	23.1 ± 4.8	27.0 ± 2.6	26.2 ± 2.9	0.0377§
Chest wall elastance (cmH₂O L⁻¹)	APRV	10.6 ± 1.8	15.4 ± 2.3	14.7 ± 1.0	19.2 ± 1.1*	15.8 ± 0.5*	0.0377§
FiO₂ (%)	LVt	1.00 ± 0.00	0.24 ± 0.03	0.27 ± 0.05	0.33 ± 0.03	0.37 ± 0.07	<0.0001§
FiO₂ (%)	APRV	1.00 ± 0.00	0.21 ± 0.00	0.21 ± 0.00	0.21 ± 0.00*	0.21 ± 0.00	<0.0001§
P_aO₂/FiO₂ (mmHg)	LVt	550.4 ± 20.1	429.4 ± 36.6	411.3 ± 39.2	269.6 ± 6.4	226.2 ± 17.1	<0.0001§
P_aO₂/FiO₂ (mmHg)	APRV	556.8 ± 27.4	443.5 ± 29.4	416.8 ± 26.5	374.6 ± 13.8*	465.7 ± 66.5*	<0.0001§

The end-expiratory pressure set on the ventilator with LVt (PEEP) and APRV (P _Low) are distinguished from the actual end-expiratory pressure measured at the level of the trachea. p value (right column) following RM ANOVA with ^§ p < 0.05 considered significant. *p < 0.05 LVt versus APRV following post hoc analysis with Tukey’s test

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