Critical Care and Shock

Airway pressure release ventilation: translating clinical research to the bedside in acute respiratory distress syndrome

Since its birth in the mid eighties of the last century, airway pressure release ventilation (APRV) has been a victim of much debate about its clinical use, benefits, and possible harms. With growing body of literature and evidence, APRV is gaining more acceptance and enthusiasm. Interesting research has been conducted in regards to its benefits in prevention of acute respiratory distress syndrome (ARDS), reduction of extra vascular lung water (EVLW), reduction in ventilator-induced lung injury (VILI), reduction of dead space, weaning off mechanical ventilation, improvement of hemodynamics, improvement in oxygenation, impact on mortality, its use as a non-invasive mode of ventilation, and its role in improving lung procurement for transplantation. The research and clinical application has expanded beyond the adult patients to include critically ill pediatric patients and critically ill animals. This article will review some of the plethora of research done in an attempt to promote its implementation to the bedside.