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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]
Mechanical ventilation is often a life-saving intervention, but carries potential complications. A common complication of positive pressure ventilation stemming directly from the ventilator settings include volutrauma and barotrauma. [11] [12] Others include pneumothorax, subcutaneous emphysema, pneumomediastinum, and pneumoperitoneum.
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.
Mandatory minute ventilation (MMV) (also called minimum minute ventilation) is a mode of mechanical ventilation which requires the operator to determine what the appropriate minute ventilation for the patient should be and the ventilator then monitors the patient's ability to generate this volume. If the calculation suggests the volume target ...
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.
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.
Applied PEEP is usually one of the first ventilator settings chosen when mechanical ventilation is initiated. It is set directly on the ventilator.. A small amount of applied PEEP (4 to 5 cmH 2 O) is used in most mechanically ventilated patients to mitigate end-expiratory alveolar collapse. [6]