Table 1 Summary of animal studies utilizing F-APRV
From: The 30-year evolution of airway pressure release ventilation (APRV)
First author | Year | n | Animal | Study design | % CPAP | TLow | Findings |
|---|---|---|---|---|---|---|---|
Stock [2] | 1987 | 10 | Mongrel dog | Crossover CPPV vs. APRV | 58 % | 1.27 s | APRV improved oxygenation with lower PIP and without cardiopulmonary compromise |
Rasanen [21] | 1988 | 10 | Mongrel dog | Crossover CPPV vs. CPAP vs. APRV | 50 % | 1.5 s | CPPV impaired circulatory function and tissue oxygen balance, APRV had higher systemic vascular resistance and decreased pulmonary vascular resistance |
Martin [17] | 1991 | 7 | Neonatal sheep | Crossover Spont vs. CPAP vs. CPPV vs. APRV | 50 % | 1 s | APRV augmented alveolar ventilation vs. CPAP, and had lower Paw than PPV without compromised cardiovascular function |
Smith [23] | 1995 | 5 | Swine | Crossover CPAP vs. APRV | 80 % | 1.1 s exp flow 0 | APRV maintains oxygenation without hemodynamic compromise |
Neumann [19] | 2001 | 9 | Swine | Crossover CPAP vs. APRV +/− PEEP | 67 % | 1 s | APRV decreased O2 compared with CPAP, No difference with PEEP |
Hering [13] | 2003 | 12 | Swine | Crossover APRV +/− SB | 50 % | N/A | APRV + SB increased oxygenation and cardiovascular function |
Wrigge [24] | 2003 | 24 | Swine | Randomized prospective APRV +/− SB | 50 % | 1.5–2 s | APRV + SB increased oxygenation and cardiovascular function |
Neumann [20] | 2005 | 20 | Swine | Randomized prospective APRV +/− SB | 50 % | 1.5 s | APRV + B increased ventilation in dependent lung and decreased shunt |
Hering [14] | 2005 | 12 | Swine | Crossover APRV vs. SB | 50 % | ~1.7 s | APRV + SB improved oxygenation after lung injury |
Wrigge [25] | 2005 | 22 | Swine | Randomized Prospective APRV +/− SB | 50 % | 1.5–2 s | APRV + SB redistributes ventilation to dependent lung regions and counters cyclic collapse |
Hering [12] | 2008 | 12 | Swine | Crossover APRV +/− SB | 50 % | N/A | APRV + SB improved oxygenation and splanchnic blood flow |
Gama de Abreu [9] | 2008 | 12 | Swine | Crossover BiPAP + SB, PSV +/− sighs, “noisy” PSV | N/A | exp flow 0 | “Noisy” CPPV improved oxygenation by redistributing perfusion |
Carvalho [7] | 2009 | 5 | Swine | Crossover PSV vs. BiPAP + SB | Titrated by Paw | N/A | BiPAP + SB and pressure support had similar oxygenation improvement and did not improve aeration of dependent lung |
Gama de Abreu [4] | 2010 | 10 | Swine | Crossover PSV vs. BiPAP + SB | 25 % | N/A | BiPAP + SB had lower tidal volume with comparable oxygenation and ventilation distribution |
Henzler [11] | 2010 | 20 | Swine | Randomized prospective APRV +/− SB | 42 % | ~1.2 s | Elevated IAH impaired respiratory mechanics regardless of SB |
Kreyer [16] | 2010 | 12 | Swine | Randomized Prospective APRV +/− SB | 50 % | 1.5–2 s exp flow 0 | APRV + SB improved systemic blood flow and cerebrospinal blood flow |
Matsuzawa [18] | 2010 | 21 | Rabbit | Randomized prospective CPPV vs. LTV vs. APRV | 95 % | 0.15 s | APRV reduced HMGB1 levels and lung water |
Slim [22] | 2011 | 7 | Swine | Case series APRV | 80 % | N/A | Increased Paw increased pulmonary capillary wedge pressure and left atrial pressure, but these may not correlate with end diastolic volume |
Xia [26] | 2011 | 24 | Rabbit | Randomized prospective APRV +/− SB | 50 % | N/A | APRV + SB improved oxygenation and attenuated VILI |
Carvalho [8] | 2014 | 36 | Swine | Randomized prospective APRV +/− SB | 50 % | N/A | APRV + SB improved oxygenation and reduced lung injury |
Guldner [10] | 2014 | 12 | Swine | Crossover APRV +/− SB | 50 % | ~1 s | Higher levels of SB reduce global lung stress and strain with minimal changes in perfusion |
Kill [15] | 2014 | 24 | Swine | Randomized prospective CPPV vs. Bilevel vs. Compression synchronized ventilation | 40 % | 3.6 s | CPPV and Bilevel usable during CPR, though compression synchronized ventilation was best |