"improving intensive care in Scotland"

Mechanical ventilation

Common modes of ventilation

We will now describe some common modes of ventilation that you will come across in ICUs in Scotland. You should be aware that every ventilator will have an algorithm for delivering a certain mode of ventilation. You should consult the ventilator manual for a detailed description of ventilation modes e.g.how and when synchronisation occurs for a particular mode of ventilation.

Ventilator mode

VC/PC

Spont/Cont

Sync

IPPV

VC or PC

Controlled

No

SIMV

VC or PC

Controlled

Yes

PCV and BiPAP

PC

Controlled

Yes

PS (or ASB)

PC

Spontaneous

Yes

VC = volume control                   Cont = controlled

PC = pressure control                 Sync = synchronised

Spont = spontaneous

IPPV = Intermittent positive pressure ventilation. Can be volume or pressure controlled, is a controlled mode of ventilation (does not require any spontaneous respiratory effort from the patient), and is not synchronised with patient's respiratory effort.

SIMV = Synchronised Intermittent mandatory ventilation. Can be volume or pressure controlled. Is a controlled mode of ventilation (does not require any spontaneous respiratory effort from the patient), and is synchronised.

PCV and BiPAP = Pressure controlled ventilation and Bilevel positive airway pressure. Are pressure controlled modes of ventilation. They are controlled modes of ventilation, but allow synchronisation if the patient takes spontaneous breaths. The two modes are slightly different in the way synchronisation occurs.

PS (ASB) = Pressure support (assisted spontaneous breathing). Is a spontaneous mode of ventilation that is pressure controlled. It is fully synchronised with the patient's breath.

SIMV and PCV are almost always combined with PS to allow the support of any spontaneous breaths that the patient takes on top of the mandatory breaths delivered.

 

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