Biphasic Positive Airway Pressure (BIPAP) and Airway Pressure Release Ventilation (APRV)is the Protective Ventilation Regime in Children without Serious Pulmonary Pathology

Overview

Thirty-four paediatric patients who needed artificial ventilation but lacked serious pulmonary pathology(ALI/ARDS) were ventilated by APRV/BIPAP. The authors investigated the acid-base equilibrium, setting of theventilator and indices of oxygenation and ventilation. In all patients satisfactory values of blood gases were achieved(pO2 11.5 kPa at time 0 and 12.3 kPa after 72 hours, pCO2 6.33 and 4.27 kPa, p < 0.05), FiO2 was reduced from0.42 to 0.33. Low pressures in the airways were achieved (Phigh 15.3 vs. 14.3, MAP 6.8 vs. 4.3, Plow 4.8 vs. 3.3, allcm H2O and of indices - AaDO2 20.2 vs. 13.2 kPa, OI 3.3 vs. 1.4, pO2/FiO2 217.3 vs. 296.6 torr (p < 0.05). Theauthors did not record any complications of artificial pulmonary ventilation, the ventilation was very well tolerated.

Key words:
artificial pulmonary ventilation, airway pressure release (APRV), biphasic positive airway pressure(BIPAP), children