Types of Assisted Ventilation Ventilator Option Indications Contraindications Controlled Mandatory No respiratory drive or Hypovolemia Ventilation (CMV) effort Assist Control Ventilation Neuromuscular disorders Hypovolemia (ACV) (Guillain-Barr) Pulmonary edema Acute respiratory failure Synchronized Intermittent Weaning Mandatory Ventilation (SIMV) Advantages

Jerry Goure Notes Delivers preset volume at a preset rate.

Pressure Support Ventilation (PSV)

Weaning (with SIMV)

Pressure Controlled Inverse Ratio (PCIR) Positive End-Expiratory Pressure (PEEP) Continuous Positive Airway Pressure (CPAP)

ARDS ARDS?

Apnea

Allows spontaneous Positive pressure during entire breath, breaths between ventilatorspontaneous or not. delivered breaths. Delivers preset volume at a preset rate. When a spontaneous breath is detected, the ventilator pushes the entire preset volume into the patient. Hypovolemia Allows spontaneous Delivers preset volume at a preset rate. breaths between ventilator- During a spontaneous breath, the padelivered breaths. tient determines the volume delivered. Improved synchrony The ventilator will push a minimbetween patient & ventilatum volume into the patient, but the or. patient can breathe deeper. Prevents atrophy of respir- work of breathing for patient. atory muscles. Most common type of ventilation. Lower mean airway pressure. Hypovolemia Helps work of breathing Patient controls the length of each Sole ventilatory and O2 demand. breath, the tidal volume, and the respirsupport for acute endurance conditioning. atory rate. respiratory failure. Prevents atrophy of respir- Delivers each breath with a preset (posatory muscles. itive) pressure. Hypovolemia Keeps alveoli open longer. I:E ratio is usually set to 2:1. Prolonged inspiratory time Unnatural breathing pattern requires may auto-PEEP. sedation and/or paralysis. Hypovolemia Keeps alveoli open during Positive pressure applied to airway durexpiration. ing expiration. Limits O2 toxicity. Mechanical equivalent to pursed-lip breathing. Hypovolemia Positive pressure applied to airway during the entire breath. Mask must be tight-fitting over face. work of breathing for patient.