Document Detail

Effects of airway pressure release ventilation on blood pressure and urine output in children.
MedLine Citation:
PMID:  19953658     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Increased intrathoracic pressures during airway pressure release ventilation (APRV) may compromise systemic venous return resulting in decreased cardiac output and renal perfusion. We sought to study the short-term effect of APRV on blood pressure (BP) and urine output (UO) in children with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS).
DESIGN: Retrospective cohort study.
PATIENTS: All patients with ALI/ARDS who were admitted to our Pediatric Intensive Care Unit (PICU) between 1/00 and 06/04, and who were ventilated with APRV (for at least 12 hr) for worsening oxygenation while on conventional ventilation (CV).
MEASUREMENTS AND RESULTS: Medical records were reviewed for patients' demographics, Pediatric Risk of Mortality (PRISM III) score, admitting diagnosis, ventilator settings, gas exchange data, heart rate (HR), central venous pressure (CVP), blood pressure (BP), UO, and use of other therapies [sedatives, pressors, inotropes, and intravenous fluid (IVF)]. Eleven patients met our inclusion and exclusion criteria with a mean age of 6.2 +/- 4.8 years (range: 1-15 years), a weight of 35.5 +/- 29.5 kg (range: 12-90 kg), and a PRISM score of 18.4 +/- 9.6 (range: 2-36). Within 10 hrs of APRV, patients' mean airway pressure (Paw) increased from 16.1 +/- 6.6 to 21.1 +/- 5.5 cm of H(2)O (P = 0.04). Despite a higher Paw there were no differences in HR, CVP, BP, UO, IVF and use of other therapies while on CV or APRV (P > 0.10).
CONCLUSION: In children with ALI/ARDS, despite a higher Paw, APRV does not affect BP or UO.
Sameer S Kamath; Dennis M Super; Maroun J Mhanna
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pediatric pulmonology     Volume:  45     ISSN:  1099-0496     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-24     Completed Date:  2010-03-30     Revised Date:  2013-02-06    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  48-54     Citation Subset:  IM    
Copyright Information:
(c) 2009 Wiley-Liss, Inc.
Division of Pediatric Critical Care, Children's Hospital of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
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MeSH Terms
Acute Lung Injury / therapy*,  urine*
Blood Gas Analysis / methods,  statistics & numerical data
Blood Pressure*
Central Venous Pressure
Child, Preschool
Cohort Studies
Continuous Positive Airway Pressure / methods*
Heart Rate
Respiratory Distress Syndrome, Adult / therapy*,  urine*
Retrospective Studies
Grant Support

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