Pressure controlled-inverse ratio ventilation.

One of the many challenges in the management of the patient with adult respiratory distress syndrome is optimal application of mechanical ventilation. Pressure controlled-inverse ratio ventilation has surfaced as a possible alternative to conventional ventilation for patients affected by this condition. In pressure controlled-inverse ratio ventilation, the conventional inspiratory-to-expiratory ratio is reversed, allowing the inspiratory phase to lengthen with an accompanying increase in mean airway pressure. When carefully applied, mean airway pressure adjustments can be manipulated without increases in positive end-expiratory pressure and peak airway pressure, thus minimizing the risk of alveolar rupture and worsening of lung injury.