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Science and Clinical Research of APRV using the TCAV Method


Although necessary to support patients with lung injury, the ventilator itself has been shown to propagate lung injury when set incorrectly. In order to prevent this ventilator-induced lung injury (VILI), protective mechanical ventilation strategies have been advocated. Although airway pressure release ventilation (APRV) is considered a rescue ventilation mode by some clinicians, it has been advocated as a pre-emptive, protective mechanical ventilation strategy based on durable clinical experience and experimental work. It is important to note that APRV, as with all modes, can be set in a multitude of ways. It has been suggested the focus of determining the impact of ventilator strategies is primarily on macro-ventilatory parameters such as tidal volume (VT) and plateau pressure (Pplat) while overlooking the lung micro-environment. In multiple experimental, clinically applicable animal studies, the time-controlled adaptive ventilation (TCAV) method of applying APRV has demonstrated improvements in oxygenation and lung function, prevention of acute respiratory distress syndrome (ARDS) and a matching reduction in micro-anatomical injury. Experimental data demonstrate that targeting the micro-environment with TCAV improves alveolar recruitment and stability, maximizes alveolar surface area without causing overdistension and improves oxygenation while stabilizing the alveoli, reducing alveolar micro-strain and preservation of surfactant protein.

Successful completion of this course requires a score of 70% on the post-test.

This course is sponsored by an unrestricted education grant from Draeger Medical Inc.

This program was provided live at AARC Congress 2020.

**Please note that all programs require the participant to view the entire program prior to taking the final quiz and obtaining a course certificate.**
2021

Approved for 1.00 CRCE Hours.


SEMINAR OBJECTIVES

Compare and contrast macro-parameters vs micro-environment
List benefits of using a ventilator strategy with emphasis on time component
Review experimental data covering alveolar recruitment and stability


CHAPTERS

Science and Clinical Research of APRV using the TCAV Method


Speaker Information

Gary Nieman, BA - Professor, Dept Surgery, Upstate Medical University, Syracuse, NY
Nader M. Habashi, MD, FACP, FCCP – Professor of Medicine, University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD


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