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Let's decode APRV.... don't trust the labels. At the baseline, you have CPAP for insp pressure, inspiratory time, expir time and pressure... and the slope... 1/2 #LIVES2019 
SO...Thigh in APRV - when shorter = no spont breathing and when longer, allows for potential spontaneous breathing. We should aim for higher Thighs due to better alveolar stability with longer exp times... 2/2 #LIVES2019
Video of alveolar stability on APRV and then with shorter insp times... #LIVES2019
Tidal volume IS adaptive - it gets better/improves with better compliance (can also be chest wall - so think about curarisation too). #LIVES2019
Tlow is used to maintain END EXPIRATORY lung function- it's literally the expiratory time. #LIVES2019 #APRV
APRV looks better in early ARDS vs (simpler) Low Tidal Volume Ventilation (2017) cont.... #LIVES2019
Fresh from 2019 - Ventilator Free Days and ICU LOS in patients with ARF favour APRV in this one RCT .... food for thought. #LIVES2019
