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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.
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 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.
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.
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.
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.
The ventilator will use the exhaled tidal volume measured at the end of that breath's expiratory phase to calculate the pressure of the next breath. If the exhaled tidal volume is lower than the software threshold, the next breath will be delivered at a higher pressure, and if the exhaled tidal volume is higher than the software threshold, the ...