Mechanical ventilation choosing amongst ventilator modes

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Choosing Amongst Ventilator Modes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]

Choosing Amongst Ventilator Modes

  • Choosing amongst the ventilator modes
  • Assist-control mode minimizes patient effort by providing full mechanical support with every breath.
  • This is often the initial mode chosen because it provides the greatest degree of support.
  • In patients with less severe respiratory failure, other modes such as SIMV may be appropriate.
  • Assist-control mode should not be used in those patients with a potential for respiratory alkalosis, in which the patient has an increased respiratory drive.
  • Such hyperventilation and hypocapnia (decreased systemic carbon dioxide due to hyperventilation) usually occurs in patients with end-stage liver disease, hyperventilatory sepsis, and head trauma.
  • Respiratory alkalosis will be evident from the initial arterial blood gas obtained, and the mode of ventilation can then be changed if so desired.
  • Positive End Expiratory Pressure may or may not be employed to prevent atelectasis.
  • High frequency oscillation is used most frequently in neonates, but is also used as an alternative mode in adults with severe ARDS.

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