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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.
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.
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.
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]
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.
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.