Is inverse ratio ventilation commonly used in anesthesia?

Inverse ratio ventilation (IRV) is not commonly used in anesthesia practice. The rationale behind this is that, under normal circumstances, the ratio of inhalation to exhalation is maintained with a focus on optimizing gas exchange and minimizing potential complications related to ventilation.

IRV, where the inspiratory phase is prolonged relative to the expiratory phase, can lead to improved oxygenation and ventilation for specific patient cases, particularly in patients with severe restrictive lung disease or those requiring high levels of positive end-expiratory pressure (PEEP). However, the complexities and potential risks associated with IRV, including the risk of auto-PEEP and difficulty in exhalation, limit its standard application in routine anesthesia practice. Therefore, it is not a common practice but may be considered in particular scenarios where its benefits outweigh these risks.