Ventilating Patient with Refractory Hypercarbia: Use of APRV Mode
A 70-year-old patient referred to our critical care unit with the diagnosis of type II respiratory failure with shock. Patient was a known case of COPD for last 20 years. His chest radiology revealed bilateral infiltrates. Patient was managed conservatively in the form of antibiotics, vasopressor...
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doaj-27df258137b94b4296f4db1ff32544202020-11-25T03:46:13ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2016-01-01101UD01UD0210.7860/JCDR/2016/16380.7016Ventilating Patient with Refractory Hypercarbia: Use of APRV ModeZia Arshad0Ravi Prakash1Swati Aggarwal2Sapna Yadav3Assistant Professor, Department of Anaesthesiology, KGMU, Lucknow, U.P, India.Senior Resident, Department of Anaesthesiology, KGMU, Lucknow, U.P, India.Junior Resident, Department of Anaesthesiology, KGMU, Lucknow, U.P, India.Junior Resident, Department of Anaesthesiology, KGMU, Lucknow, U.P, India.A 70-year-old patient referred to our critical care unit with the diagnosis of type II respiratory failure with shock. Patient was a known case of COPD for last 20 years. His chest radiology revealed bilateral infiltrates. Patient was managed conservatively in the form of antibiotics, vasopressor and ventilatory support with SIMV/VC mode. After ventilation with SIMV/VC mode for half an hour his blood gases revealed increasing PaCO2 levels. The same result was obtained with PC mode and ASV and his PaCO2 level reached above 170 mmHg. Then APRV mode was tried with modified settings. The results obtained were satisfactory and in next 24 hours PaCO2 decreased to <66mmHg along with an increasing P/F ratio. APRV is the not recommended as primary mode of ventilation in COPD but in resistant cases it can be helpful as it improves alveolar recruitment and pressure support is added to reduce hypercapnia.https://jcdr.net/articles/PDF/7016/16380_CE[Ra1]_F(AK)_PF1(VIAK)_PFA(AK)_PF2(PAG).pdfcopdhypercapniasimvrespiratory failure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zia Arshad Ravi Prakash Swati Aggarwal Sapna Yadav |
spellingShingle |
Zia Arshad Ravi Prakash Swati Aggarwal Sapna Yadav Ventilating Patient with Refractory Hypercarbia: Use of APRV Mode Journal of Clinical and Diagnostic Research copd hypercapnia simv respiratory failure |
author_facet |
Zia Arshad Ravi Prakash Swati Aggarwal Sapna Yadav |
author_sort |
Zia Arshad |
title |
Ventilating Patient with Refractory Hypercarbia: Use of APRV Mode |
title_short |
Ventilating Patient with Refractory Hypercarbia: Use of APRV Mode |
title_full |
Ventilating Patient with Refractory Hypercarbia: Use of APRV Mode |
title_fullStr |
Ventilating Patient with Refractory Hypercarbia: Use of APRV Mode |
title_full_unstemmed |
Ventilating Patient with Refractory Hypercarbia: Use of APRV Mode |
title_sort |
ventilating patient with refractory hypercarbia: use of aprv mode |
publisher |
JCDR Research and Publications Private Limited |
series |
Journal of Clinical and Diagnostic Research |
issn |
2249-782X 0973-709X |
publishDate |
2016-01-01 |
description |
A 70-year-old patient referred to our critical care unit with the diagnosis of type II respiratory failure with shock. Patient was a known case
of COPD for last 20 years. His chest radiology revealed bilateral infiltrates. Patient was managed conservatively in the form of antibiotics,
vasopressor and ventilatory support with SIMV/VC mode. After ventilation with SIMV/VC mode for half an hour his blood gases revealed
increasing PaCO2
levels. The same result was obtained with PC mode and ASV and his PaCO2
level reached above 170 mmHg.
Then APRV mode was tried with modified settings. The results obtained were satisfactory and in next 24 hours PaCO2
decreased to
<66mmHg along with an increasing P/F ratio. APRV is the not recommended as primary mode of ventilation in COPD but in resistant
cases it can be helpful as it improves alveolar recruitment and pressure support is added to reduce hypercapnia. |
topic |
copd hypercapnia simv respiratory failure |
url |
https://jcdr.net/articles/PDF/7016/16380_CE[Ra1]_F(AK)_PF1(VIAK)_PFA(AK)_PF2(PAG).pdf |
work_keys_str_mv |
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