Hemodynamic Changes in Child Acute Respiratory Distress Syndrome with Airway Pressure Release Ventilation, A Case Series.

The clinical respiratory journal

PubMedID: 24761938

Kawaguchi A, Guerra GG, Duff JP, Ueta I, Fukushima R. Hemodynamic Changes in Child Acute Respiratory Distress Syndrome with Airway Pressure Release Ventilation, A Case Series. Clin Respir J. 2014;.
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 hours 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±15.0kg, a mean age of 68±57months, 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 or 12 hours of APRV when compared to 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.

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