Inverse
Ratio Ventilation (IRV) is a subset of (Pressure-controlled ventilation)PCV in
which inflation time is prolonged (In IRV, I:E ratio of 1:1, 2:1, or 3:1 may be
used)
A
decrease in inspiratory flow rate is used to prolong the time for lung
inflation.
This
lowers peak airway pressures but increases mean airway pressures. The prolonged
inflation
time can help prevent alveolar collapse.
However,
prolonged inflation times also increase the tendency for inadequate emptying of
the lungs, which can lead to hyperinflation and auto-PEEP.
Drawback - The tendency to produce auto-PEEP can lead to a decrease
in cardiac output
Indication - patients with ARDS who have refractory hypoxemia during conventional modes
of mechanical ventilation.
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