Comparison of airway pressure release ventilation to conventional mechanical ventilation in the early management of smoke inhalation injury in swine

OBJECTIVE:The role of airway pressure release ventilation in the management of early smoke inhalation injury has not been studied. We compared the effects of airway pressure release ventilation and conventional mechanical ventilation on oxygenation in a porcine model of acute respiratory distress syndrome induced by wood smoke inhalation. DESIGN:Prospective animal study. SETTING:Government laboratory animal intensive care unit. PATIENTS:Thirty-three Yorkshire pigs. INTERVENTIONS:Smoke inhalation injury. MEASUREMENTS AND MAIN RESULTS:Anesthetized female Yorkshire pigs (n = 33) inhaled room-temperature pine-bark smoke. Before injury, the pigs were randomized to receive conventional mechanical ventilation (n = 15) or airway pressure release ventilation (n = 12) for 48 hrs after smoke inhalation. As acute respiratory distress syndrome developed (PaO2/Fio2 ratio