Volume 1 Supplement 1

17th International Symposium on Intensive Care and Emergency Medicine

Open Access

Nasal-airway pressure release ventilation (NASAL-APRV) and nasal-continuous positive airway pressure (NASAL-CPAP): hemodynamic, respiratory and gasometric effects

  • LP Fascina1,
  • BI Kopelman1,
  • J Bonassa1 and
  • WB Carvalho1
Critical Care19971(Suppl 1):P063

https://doi.org/10.1186/cc62

Published: 1 March 1997

This study compared the NASAL-CPAP to a new mode called NASAL-APRV as a non-invasive weaning procedure from mechanical ventilation using nasal prongs, analysing the hemodynamic, respiratory and gasometric effects.

Data were collected in a randomized and prospective protocol, applied to pediatric patients (minimum age, 10 days; maximum age, 10 years 6 months; mean age, 1 year 8 months 12 days), totalling n = 17 cases. For each patient the mean airway pressure was kept constant for both modes of ventilation, 4.5 ± 0.65 cmH2O. In NASAL-APRV the maximum distension pressure ranged from 5 to 8 cmH2O and the release pressure was always to 0 cmH2O; release time was 1.0s and release frequency of 15 rpm. NASAL-CPAP was kept between 3 to 5 cmH2O. FiO2 was 40%. Statistical analysis: Wilcoxon signed-rank test.

Conclusions

In the hemodynamic effects there was a significant alteration only in heart rate, lowering in the NASAL-APRV. In the respiratory and gasometric changes there is a significant alteration towards improval both in oxygenation and ventilation, achieved with a better respiratory comfort.

Table

Variables

NASAL-CPAP

NASAL-APRV

P

 

Mean

SD

Mean

SD

 

HR (beat/min)

136.95

22.66

129.47

24.87

0.0017

MAP (mmHg)

73.94

19.96

72.94

20.02

NS

ExtO2 (%)

23.88

10.8

22.88

9.23

NS

RR (resp/min)

41.65

14.71

36.94

12.79

0.002

pHart

7.39

0.06

7.39

0.05

NS

PaO2(mmHg)

85.59

29.92

95.65

32.05

0.0052

PaCO2 (mmHg)

37.06

8.27

32.82

6.02

0.0002

SatartO2 (%)

93.47

5.7

94.77

4.91

0.0362

HR, heart rate; MAP, mean arterial pressure; RR, child's respiratory rate.

Authors’ Affiliations

(1)
PICU, Department of Pediatrics UNIFESP/EPM

Copyright

© Current Science Ltd 1997

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