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Pressure-cycled modes

PSV,PCV,CPAP,BIPAP

Volume-controlled modes

Control,Assist,A/C,IMV,SIMV

Pressure support vent. (PSV)

Pt. determines RR ,Ve and I-time-purely spontaneous mode

Pressure support vent. (PSV)

triggered by patients own breath,Limitied by pressure

Pressure support vent. (PSV)

is used to complement volume cycled modes Ex.SIMV,PSV alone is used for recovery of intubated patients who are not ready for extubation,augments inflation volumes during spontanious breaths,BiPAP=CPAP+PS

Pressure Control(PCV)

vent determines I-Time-no Pt. participation

Pressure Control(PCV)

Time triggered ,Pressure limited, Dis.-requires frequent adjustments to maintain adequate Ve

CPAP & BiPAP

CPAP is constant PEEP;BIPAP is CPAP +PS

Control mode

vent delivers fixed volume,Pt recieves a set number of breaths and cannot breathe between vent breaths similar to pressure control

Assist mode

vent delivers fixed volume,Pt. initiates all breaths,but vent cycles in at initiationto give a preset Vt,Pt controls rate but always recives full machine breath

A/C Mode

ventilator delivers fixed volume,it;s in assist mode unless Pt's respiratory rate falls below preste value,If RR fallvent then swithches to control mode

IMV

Volume cycled mode typically augmented with PS,Pt recieves a set number of vent breaths,differnt from control;Pt can initiate own spontaneous breath,different than Assist:Spont. breaths are not supported by machine with fixed Vt,Vetn always delivers breath even if Pt. is exhaling

SIMV

most commonly used mode,consists of both spont. and mandatory breaths,If Pt has respiratory drive the mandatory breaths are synchronized with the Pt's inspiratiry effort

I:E ratio (IRV)

-increasing I-Time will increase Vt, but may lead to Auto-PEEP,better gas distribution with lower PIP

PIP

-elevated PIP suggests need for switch from vloume controlled to Pressure controlled ventilation-Maintained at <45cmH2O

Plateau Pressure

-Pressure maintained at the end of insp. phase-maintained at <30 cm H2O

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