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2020, Number 4

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Rev Cub Med Int Emerg 2020; 19 (4)

Airway pressure release ventilation in refractory hypoxemia

Montero QN, Hernández BC, Santiago RD, Busto LPI

Language: Spanish
References: 30
Page: 1-24
PDF size: 502.84 Kb.


ABSTRACT

Introduction: Approximately 10% of deaths from acute respiratory distress syndrome are attributable to hypoxemia. The inability to solve it with conventional respiratory support is a problem. Airway pressure release ventilation offers theoretical advantages in the treatment of hypoxemia.
Objective: To compare the effects of ventilation with pressure release in the airway and volume control with auto flow in patients with severe and refractory acute respiratory distress syndrome.
Methods: An observational investigation was carried out in the Intensive Care Unit at Comandante Manuel Fajardo Rivero University Hospital, in Santa Clara, from January 2015 to August 2019. The 23 patients that made up the sample were distributed into two groups: 13 received volume control with auto flow; and 10, ventilation with pressure release in the airway. The T test was applied for the equality of means in the variables with normal distribution. The variation of the mean was analyzed to determine if there were differences in the behavior of the variables studied.
Results: The average behavior of the pressures was lower in the group with ventilation with pressure release in the airway: high pressure (22.45 mbar vs. 32.37 mbar) and PEEP (9.29 mbar vs. 15.39 mbar), PaO2 (86.20mbar vs. 75.02mbar), PO2 / FiO2 ratio (228.18 vs. 129.39) and the oxygenation index (14.87 vs. 22.60) were significantly higher in the patients of the ventilated group with release of pressure in the airway.
Conclusions: Patients who received airway pressure release ventilation achieved significant improvement in oxygenation compared to those in the volume control group with auto flow; they also had fewer days of cardio circulatory support. Neuromuscular blockade and sedation requirements were significantly higher in the auto flow volume control group. There were no differences in the incidence of complications attributable to mechanical artificial ventilation.


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