Papadakos PJ, Halloran W, Hessney JI, Lund N, Feliciano DV
A key element in the treatment of Adult Respiratory Distress Syndrome (ARDS) is improvement in oxygen delivery to match metabolic demands. Conventional modes of ventilation have decreased mortality (50%) very little. We have done a retrospective analysis of 30 surgical patients who were treated with pressure-controlled inverse ratio ventilation. Mortality was 10%. Arterial oxygenation improved from 40.8 +/- 12.2 mm Hg to 138 +/- 47.2 mm Hg, while PCO2 decreased from 37.8 +/- 7.6 mm Hg to 31.1 +/- 5.9 mm Hg. Simultaneously, with the use of pressure-controlled inverse ratio ventilation, minute ventilation could be decreased by 30%, which may be secondary to increased O2 delivery to the tissue. Our data indicate that pressure-controlled inverse ratio ventilation may be beneficial to surgical patients with ARDS.
Department of Surgery, Strong Memorial Hospital, University of Rochester, New York.