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Modes of mechanical ventilation are one of the most important aspects of the usage of mechanical ventilation.The mode refers to the method of inspiratory support. In general, mode selection is based on clinician familiarity and institutional preferences, since there is a paucity of evidence indicating that the mode affects clinical outcome.
There are many modes of mechanical ventilation. [1] In medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous breathing. A breath by breath trigger, limit, cycling (TLC) classification of the common modes of ventilation. (V = ventilator; P = patient) [2]
Modes of mechanical ventilation has only had an established nomenclature since 2008. [1] It is suggested that the modes categorized under the following sections be referred to as their section header instead of their individual name, which is often a brand name instead of the preferred nomenclature.
Continuous mandatory ventilation (CMV) is a mode of mechanical ventilation in which breaths are delivered based on set variables. Still used in the operating room, in previous nomenclature, CMV referred to "controlled mechanical ventilation" ("control mode ventilation"), a mode of ventilation characterized by a ventilator that makes no effort to sense patient breathing effort.
The method for monitoring whether or not the patient is meeting the required minute ventilation (V E) is different per ventilator brand and model, but generally there is a window of time being monitored and a smaller window being checked against that larger window (i.e., in the Dräger Evita® line of mechanical ventilators there is a moving 20 ...
For those who need to be intubated, however, Marik and his colleagues are also recommending a different, gentler approach than the high-pressure ventilator settings typically used for patients ...
There is a standardized nomenclature of mechanical ventilation that is specific about nomenclature related to modes, but not settings and variables. [2] Terms are now split into acronyms of CONTROL VARIABLE + BREATH SEQUENCE + TARGETING SCHEME. As in PC-CMV, Pressure Controlled Continuous Mandatory Ventilation.
Airway pressure release ventilation (APRV) is a pressure control mode of mechanical ventilation that utilizes an inverse ratio ventilation strategy. APRV is an applied continuous positive airway pressure (CPAP) that at a set timed interval releases the applied pressure. Depending on the ventilator manufacturer, it may be referred to as BiVent.