Despite ubiquitous acceptance, data supporting traditional Acute Respiratory Distress Syndrome Network lung-protective strategies are far more controversial than their fabled repute. Conversely, despite its physiologically pleasing underpinning and positive preclinical data, airway pressure release ventilation (APRV) has garnered little support from the critical care community, primarily due to a lack of robust, high-quality clinical data. Therefore, Zhou et al (Intensive Care Med. 2017; 43(11):1648-1659) set out to see whether early application of APRV in patients with acute respiratory distress syndrome (ARDS) would allow pulmonary function to recover faster and would reduce the duration of mechanical ventilation compared with low tidal volume lung protective ventilation (LTV).
They found that, compared with LTV, APRV in patients with ARDS improved oxygenation and respiratory system compliance, decreased plateau pressure, and reduced the duration of both mechanical ventilation and intensive care unit stay.
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