Ventilation modes

Modes

Preset rate and TV
Patient able to trigger additional breaths (full assisted tidal volume)
Spontaneous breathing (above rate) is not allowed
Beneficial for patients requiring a high minute-ventilation (reduces oxygen consumption and CO2 production of the respiratory muscles)
May worsen obstructive airway disease by air trapping or breath stacking
Set: RR, FiO2, PEEP, TV, I:E ratio

Senses not to give with breathing if present, extra breaths of patient's TV
Preset breaths in coordination with the respiratory effort
Spontaneous breathing allowed between breaths
Synchronization attempts to limit the barotrauma by not delivering a breath when already maximally inhaled (vs. IMV)
For each additional breath triggered by pt, ventilator delivers variable TV depending on patient effort and condition of lung
Because of need for patient effort, not recommended for tired or septic pt
Set: RR, FiO2, PEEP, TV, I:E ratio

^For the paralyzed patient, there is no difference in minute-ventilation or airway pressures between A/C and SIMV

Controls via pressure, good if pressures getting too high
Limits barotrauma and decreases the work of breathing in the spontaneously breathing patient
Level of pressure set (not TV) to assist spontaneous efforts
Most ventilators allow back-up respiratory rate (in case of apnea)
Mode of choice in patients whose respiratory failure is not severe and who have an adequate respiratory drive (improved patient comfort, reduced cardiovascular effects, reduced risk of barotrauma, and improved distribution of gas)
Set: RR, FiO2, PEEP, PS, I:E ratio

Provides constant pressure through inspiration with decelerating inspiratory flow pattern
Ventilator adjusts pressure breath to breath based on patient’s airway resistance and compliance
Benefits: minimum PIP, guaranteed tidal volume, patient can trigger more breaths, improved oxygenation, breath by breath changes
Not recommended for asthma or COPD
Set: FiO2, RR, TV, upper pressure limit, I:E ratio, PEEP