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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
  1. Number of studies: 22
  2. T Low time at low pressure, CPPV conventional positive pressure ventilation, LTV low tidal volume ventilation, CPAP continuous positive airway pressure, SB spontaneous breathing, PEEP positive end-expiratory pressure, PIP peak inspiratory pressure, P aw airway pressure, PSV pressure support ventilation, BiPAP biphasic positive airway pressure