| Title: |
Outcome and Oxygenation Response to Airway Pressure Release Ventilation (APRV) Used as a Rescue Strategy for Severe Hypoxemic Respiratory Failure—An Observational Study |
| Authors: |
Harriet Jacobs; Mark Brown; Elizabeth Webb; Olivia Cox; Isis Terrington; Tanvi Dabke; Diana David; Benjamin Eastwood; Ryan Beecham; Michael P. W. Grocott; Ahilanandan Dushianthan |
| Source: |
Journal of Clinical Medicine ; Volume 15 ; Issue 7 ; Pages: 2668 |
| Publisher Information: |
Multidisciplinary Digital Publishing Institute |
| Publication Year: |
2026 |
| Collection: |
MDPI Open Access Publishing |
| Subject Terms: |
mechanical ventilation; APRV; oxygen; intensive care |
| Description: |
Background and objectives: Airway pressure release ventilation (APRV) is an inverse ratio ventilation often used as a rescue method for patients with severe acute hypoxemic respiratory failure (AHRF). This observational cohort study aims to evaluate the outcomes of APRV for patients with severe AHRF. Methods: We conducted a retrospective observational cohort study of patients with AHRF requiring APRV. The primary outcome was early physiological response, defined as the change in PaO2/FiO2 (P/F ratio) within 6 h of APRV initiation. Secondary outcomes included ICU mortality, duration of mechanical ventilation, and length of stay. Results: Between 01/2018 and 09/2024, 152 patients had APRV initiated for >2 h. P/F ratio improved in 64% of patients (responders). Responders had more severe hypoxemia before APRV initiation (P/F ratio 9.8 vs. 10.4 kPa, p = 0.05) and showed a greater improvement within 6 h following APRV initiation (18.8 vs. 11.9 kPa, p < 0.01). Overall survival to ICU discharge was 56%. There were no differences in ICU survival or liberation from mechanical ventilation between responders and non-responders (log-rank p = 0.48 and 0.96). There were also no differences in improvement in oxygenation following APRV or mortality between COVID-19 and non-COVID-19 patients. Conclusions: APRV may improve oxygenation in the short term, but this improvement in oxygenation was not associated with improved clinical outcomes in this observational cohort. |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Intensive Care; https://dx.doi.org/10.3390/jcm15072668 |
| DOI: |
10.3390/jcm15072668 |
| Availability: |
https://doi.org/10.3390/jcm15072668 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.D04AFAA9 |
| Database: |
BASE |