Vent Modes

Mechanical: Volume Assist / Controlled

SET: Tidal volume (Vt) and RR

All breaths get the VT

Pt can have normal respiratory drive

Vent compensates for: Insufficient work of breathing

(post-surgery, sedation, paralyzed, pneumonia). NOT indicated for COPD pts

Common modes: AC/VC, V-AC, IMV, V-IMV, SIMV

Mechanica: Pressure Controlled

SET: inspiratory pressure

Some modes require Pt to have a fully functioning respiratory drive.

Vent compensates for: diminished lung compliance or atelectasis

Common modes:• P-AC, PC, PCV, PSV, CPAP

Volume: Assist Control / Volume Control (AC/VC, V-AC)

(basically the generalized stuff from flash card 1)

Set: Vt, RR, and I:E ratio

• Every breath is supported whether assisted (Pt initiated) or controlled (vent initiated) and will receive the full Vt

• Common uses: Post-op, Pneumonia, sedation, paralyzation

• Most common mode of ventilation

Volume: Volume Intermittent Mandatory Ventilation

(V-IMV, IMV, SIMV)

• Set: Vt & RR

• Pt can trigger spontaneous breaths between mandatory set breaths BUT

the Vt of the spontaneous breath will vary

• Patient must have respiratory drive; monitor RR closely and do not use NMB

medications

• Common uses: weaning and fixing WOB, resp muscles, hyperventilation has occured

Pressure: Pressure Assist/Control

(P-A/C, PC, PCV)

• Set inspiratory pressure and RR 15-25

Pressure sent during mandatory/spontaneous inspiration

• Considered a lung protective mode

• Common uses: ARDS, high PIP, noncompliant lungs

Pressure Support (PSV)

Preset inspiratory pressure BUT the patient initiates every breath and must have an adequate respiratory drive and WOB

6-12

• Common uses: weaning or in addition to other mode, reconditioning resp muscles

Continuous Positive Airway Pressure (CPAP)

-positive airway applied during expiration

BUT the patient initiates every breath and preforms all the WOB/ NEEDS RESP DRIVE

• Common uses: weaning (SBT) or OSA

• Stand alone PEEP

Hybrid: Airway Pressure Release Ventilation

(APRV)

• Set high and low pressures

• Second line use in ARDS

Hybrid: Pressure Regulated Volume Control (PRVC)

• Set Vt and RR but Pt can take spontaneous breaths.

- breaths are vent initiated OR patient initiated

-pressure during inspiration

• lowest amount of pressure to achieve set Vt from breath to breath

-monitors each breath and compares the delivered tidal volume with the set tidal volume.

-if the delivered volume is too low it increases the inspiratory pressure on the next breath.

-if it is too high it decreases the pressure

• Common uses: Post-op and Pneumonia