Ventilators: Modes of ventilation or methods of ventilator support

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Modes of ventilation or methods of ventilator support
  1. Controlled ventilation
  2. Assist control ventilation
  3. Synchronized intermittent mandatory ventilation (SIMV)
  4. Pressure support ventilation

  1. Controlled ventilation or controlled mandatory ventilation (CMV)
  • Delivers preset tidal volume at preset respiratory rate
  • This mode ventilates the patient regardless of inspiratory effort.
  • This effectively "locks out" the patient's effort to breathe.
  • May be ordered for the patients who have no inspiratory effort, such as high cervical spine injuries.
  • Also used for those patients who receive chemical paralysis as part of their medical treatment.
  • Eg. Flail chest injury or head injury.
  • Rarely used mode

  1. Assist control (A/C) (ACV)
  • Delivers preset tidal volume whenever patient exerts a negative inspiratory effort (trigger).   
  • A preset respiratory rate ensures that the patient receives adequate ventilation regardless of spontaneous efforts.
  • For example: A/C respiratory rate may be set at 10 breaths per minute at tidal volume of  800ml. If the patient initiates a negative inspiratory effort 16 times per minute, he or she will receive 800ml of air for each of 16 efforts.
  • If the patient does not initiate any inspiratory effort he or she receives 800 ml of tidal volume 10 times per minute.
  • Useful for the patients with normal respiratory drive and who are unable to sustain a normal tidal volume.
  • Complication is respiratory alkalosis, especially if the patient’s respiratory rate is very high.

  1. Synchronized intermittent mandatory ventilation (SIMV)
  • This mode delivers a preset tidal volume at a preset mandatory respiratory rate and permits the patient to breathe spontaneously at his or her own respiratory rate and depth between the ventilator breaths.
  • The preset breaths are synchronized with the patient’s spontaneous efforts and helps to prevent patient-ventilator dys-synchrony.
  • Helps to prevent respiratory muscle weakness and hyperventilation.
  • Often ordered as a method for weaning patients from mechanical ventilation.
  1. Pressure support ventilation (PSV)
  • Preset level of positive pressure is applied for the duration of a spontaneous breath
  • Allows more even distribution of inspired gas.
  • Augments a patients spontaneous tidal volume and decreases the work of breathing (WOB) associated with spontaneous breathing through an artificial airway.

  1. Pressure controlled ventilation (PCV)

  • Generates the preset pressure during a preset inspiratory time at the preset respiratory rate.

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notes.nursium.com: Ventilators: Modes of ventilation or methods of ventilator support
Ventilators: Modes of ventilation or methods of ventilator support
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