目的：采用Meta分析探究气道压力释放通气(APRV)对急性呼吸窘迫综合征(ARDS)患者的有效性，并与传统的机械通气模式进行对比。方法：通过检索PubMed、Cochrane、Embase和中国知网等数据库，收集从建库至2022年6月公开发表的关于APRV对ARDS患者疗效的随机对照试验(RCT)研究，研究的APRV组采用APRV，对照组采用传统机械通气模式，结局指标包括住院死亡率、ICU住院时间及氧合指数；排除观察性研究、病例报告、动物研究等文献类型。结果：纳入12篇文献，共706例患者，其中APRV组356例、对照组350例。结果显示APRV能够显著降低ARDS患者住院死亡率(RR=0.66，95%CI 0.52~0.84，P=0.001)，缩短ARDS患者ICU住院时间(MD=0.72，95%CI -1.49~0.05，P=0.048)，改善ARDS患者氧合指数(MD=1.69，95%CI 0.89~2.49，P=0.001)。结论：APRV较传统机械通气模式能够降低ARDS患者住院死亡率、缩短ARDS患者ICU住院时间、改善ARDS患者氧合指数，APRV对ARDS患者来说是一种更为安全有效的通气模式。

[1] 李森,任敏,齐军,等.血清尿酸水平预测ARDS患者预后的临床观察研究[J].现代医学,2020,48(12):1550-1555.
[2] STOCK M C,DOWNS J B,FROLICHER D A.Airway pressure release ventilation[J].Crit Care Med,1987,15(5):462-466.
[3] KAPLAN L J,BAILEY H,FORMOSA V.Airway pressure release ventilation increases cardiac performance in patients with acute lung injury/adult respiratory distress syndrome[J].Crit Care,2001,5(4):221-226.
[4] 宋邵华,田惠玉,杨秀芬,等.气道压力释放通气应用于急性肺损伤/急性呼吸窘迫综合征患者的临床研究[J].中华危重病急救医学,2016(1):15-21.
[5] VARPULA T,JOUSELA I,NIEMI R,et al.Combined effects of prone positioning and airway pressure release ventilation on gas exchange in patients with acute lung injury[J].Acta Anaesthesiol Scand,2003,47(5):516-524.
[6] MAXWELL R A,GREEN J M,WALDROP J,et al.A randomized prospective trial of airway pressure release ventilation and low tidal volume ventilation in adult trauma patients with acute respiratory failure[J].J Trauma,2010,69:501-511.
[7] PUTENSEN C,ZECH S,WRIGGE H,et al.Long-term effects of spontaneous breathing during ventilatory support in patients with acute lung injury[J].Am J Respir Crit Care Med,2001,164(1):43-49.
[8] VARPULA T,VALTA P,NIEMI R,et al.Airway pressure release ventilation as a primary ventilatory mode in acute respiratory distress syndrome[J].Acta Anaesthesiol Scand,2004,48(6):722-731.
[9] LI J W,LIANG Y.The comparative observation of lung protective effect between APRV and low tide volume(A/C) ventilation mode on ARDS patients[J].BMU J,2011,34:127-129.
[10] LI J Q,LI N,HAN G J,et al.Clinical research about airway pressure release ventilation for moderate to severe acute respiratory distress syndrome[J].Eur Rev Med Pharmacol Sci,2016,20(12):2634-2641.
[11] ZHOU Y,JIN X,LV Y,et al.Early application of airway pressure release ventilation may reduce the duration of mechanical ventilation in acute respiratory distress syndrome[J].Intensive Care Med,2017,43(11):1648-1659.
[12] HIRSHBERG E L,LANSPA M J,PETERSON J,et al.Randomized feasibility trial of a low tidal volume-airway pressure release ventilation protocol compared with traditional airway pressure release ventilation and volume control ventilation protocols[J].Crit Care Med,2018,46(12):1943-1952.
[13] 董志丹.气道压力释放通气模式对急性呼吸窘迫综合征患者的治疗效果分析[J].现代医学与健康研究(电子版),2021,5(18):16-19.
[14] 兀瑞俭,詹晓娟,郭发瑞,等.俯卧位通气联合气道压力释放通气模式对中重度急性呼吸窘迫综合征患者的疗效观察[J].临床急诊杂志,2021,22(10):667-672.
[15] 岳伟岗,向飞,张莹,等.急性呼吸窘迫综合征患者早期应用气道压力释放通气的疗效[J].中华危重症医学杂志(电子版),2020,13(2):93-99.
[16] 刘小毅,刘慧,冉慧,等.气道压力释放通气在治疗重度急性呼吸窘迫综合征患者中的应用观察[J].四川医学,2019,40(9):947-951.
[17] 李娜,李家琼,韩冠杰,等.气道压力释放通气治疗中重度急性呼吸窘迫综合征的临床研究[J].中国急救医学,2015,4:346-350,351.
[18] HABASHI N M.Other approaches to open-lung ventilation:airway pressure release ventilation[J].Crit Care Med,2005,33:S228-S240.
[19] DAOUD E G,FARAG H L,CHATBURN R L.Airway pressure release ventilation:what do we know?[J].Respir Care,2012,57:282-292.
[20] ANDREWS P,HABASHI N.Airway pressure release ventilation[J].Curr Probl Surg,2013,50(10):462-470.
[21] CAZA T,LANDAS S.Functional and phenotypic plasticity of CD4(+) T cell subsets[J].Biomed Res Int,2015,2015:521957.
[22] YEHYA N,HARHAY M O,CURLEY M A Q,et al.Reappraisal of ventilator-free days in critical care research[J].Am J Respir Crit Care Med,2019,200(7):828-836.
[23] EMR B,GATTO L A,ROY S,et al.Airway pressure release ventilation prevents ventilator-induced lung injury in normal lungs[J].JAMA Surg,2013,148(11):1005-1012.
[24] ROY S,SADOWITZ B,ANDREWS P,et al.Early stabilizing alveolar ventilation prevents acute respiratory distress syndrome:a novel timing-based ventilatory intervention to avert lung injury[J].J Trauma Acute Care Surg,2012,73:391-400.
[25] YOSHIDA T,RINKA H,KAJI A,et al.The impact of spontaneous ventilation on distribution of lung aeration in patients with acute respiratory distress syndrome:airway pressure release ventilation versus pressure support ventilation[J].Anesth Analg,2009,109(6):1892-1900.