APRV IN PEDIATRIC TRAUMA PATIENTS

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Dutch and members:

Does anyone out there have any experience with APRV (Airway Pressure Release Ventilation) in kids?? We have been using in this in adults and I am now trialing this with our kids in the trauma bay, however, our pediatric intensivists are unfamiliar with this mode.? 

We had a great save with this mode in a 4yo who was ejected with a severe TBI, extensive B pulmonary contusions, and aspiration.? We were unable to oxygenate or ventilate her on either conventional?volume or pressure control.? She was placed on APRV (BI-VENT/BI-LEVEL) with marked improvement, however, was taken off for an emergent crani.? The anesthesiologists were again unable to oxygenate or ventilate and we placed her back on APRV.? The peds intensivist wanted to try her on the oscillator, but we were able to convince them to stay on APRV.? She has done remarkably well from a resp standpoint, although she remains with a GCS of 5T.? 

Any help, anecdotal or otherwise is appreciated.

Dell..............


Forrest "Dell" Moore, MD, FACS
Trauma Critical Care Surgery
Co-director Trauma & Surgical ICU
St. Joseph's Hospital and Medical Center
Phoenix, AZ
Cell 480 284 1703

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