What is a conventional ventilator? Conventional ventilators are commonly used in the intensive care unit to oxygenate intubated patients, and are in short supply during the COVID19 pandemic.
Find our complete video library only on Osmosis Prime: http://osms.it/more.
Hundreds of thousands of current & future clinicians learn by Osmosis. We have unparalleled tools and materials to prepare you to succeed in school, on board exams, and as a future clinician. Sign up for a free trial at http://osms.it/more.
Subscribe to our Youtube channel at http://osms.it/subscribe.
Get early access to our upcoming video releases, practice questions, giveaways, and more when you follow us on social media:
Facebook: http://osms.it/facebook
Twitter: http://osms.it/twitter
Instagram: http://osms.it/instagram
Our Vision: Everyone who cares for someone will learn by Osmosis.
Our Mission: To empower the world’s clinicians and caregivers with the best learning experience possible. Learn more here: http://osms.it/mission
Medical disclaimer: Knowledge Diffusion Inc (DBA Osmosis) does not provide medical advice. Osmosis and the content available on Osmosis’s properties (Osmosis.org, YouTube, and other channels) do not provide a diagnosis or other recommendation for treatment and are not a substitute for the professional judgment of a healthcare professional in diagnosis and treatment of any person or animal. The determination of the need for medical services and the types of healthcare to be provided to a patient are decisions that should be made only by a physician or other licensed health care provider. Always seek the advice of a physician or other qualified healthcare provider with any questions you have regarding a medical condition.
Its not easy to understand for someone who is a begginer. Anyway, lots of thank you.
This might help anyone curious about ventilator modes.
Ventilation Modes
Mechanical Ventilators have many ways they can provide pressure to support breathing, and each different way is called a “Mode.” There are three main type of breaths a mode may give, and the way a mode uses these breath types will determine when and how pressure is delivered to the patient.
Breath Types
Spontaneous Breath
The patient has full control of the respiratory rate and inspiratory time. Sensitivity setting detects efforts to initiate a breath and a drop in inspiratory flow signals the end of the breath.
Assisted Breath
These breaths are triggered by the patient, but last for a set inspiratory time before allowing exhalation. This gives the ventilator more control over how the breath goes in, while allowing the patient to decide when it happens.
Mandatory Breath
These breaths are started on a timer based on the set respiratory rate, and last for a set inspiratory time.
Modes
(Different manufacturers will have different names they use for each of their modes, but regardless of the proprietary name, the following modes are present in nearly all ventilators under some name or another. In general, no mode has been shown to be superior to others. Rather, each mode has its uses, and the modes you’re more comfortable with are the ones you’ll use most effectively.)
IMV (Intermittent Mandatory Ventilation)
A historical mode that delivers only mandatory breaths, as it has no ability to sense patient efforts. All modern ventilators have the capacity to sense a patient effort and give a breath, so you will NOT see this mode used or even available today.
PS (Pressure Support)
In this mode, all breaths are spontaneous, giving the patient full control of their respiratory cycles. A set amount of inspiratory pressure (called Pressure Support) is given when the patient initiates a breath, and a set Positive End-Expiratory Pressure (PEEP) is given when the patient begins to exhale. A backup mode is usually set to kick in if the patient stops breathing.
PC (Pressure Control)
This mode uses a mix of Assisted and Mandatory Breaths where the ventilator always has control over the inspiratory time and inspiratory pressure, and ensures that the patient breathes at or above a set respiratory rate. The inspiratory pressure is set to give breaths that are approximately large enough to support adequate ventilation, but inspiratory flows are variable and there is no specific control of tidal volume. This can be a more flexible and comfortable mode for patients to breath on, but for those who are very sick, it has some drawbacks. Small changes in patient effort, and the condition of the patient’s lungs (compliance and resistance) can have a significant impact on the amount of ventilation the patient gets.
VC (Volume Control)
Volume Control is similar to Pressure Control, except that instead of delivering a set pressure over the inspiratory time, Volume Control delivers a set volume that it pushes regardless of the generated inspiratory pressure (usually a max allowable pressure is set though). Inspiratory flows are set, and not variable like in Pressure Control. This breath type is more rigid, and does not permit patients to modify flow rates during the breath. As a result, ventilation is more consistent and controlled, which is useful for sick patients. It also allows us to follow ARDS guidelines with regards to tidal volumes.
SIMV (Synchronized Intermittent Mandatory Ventilation)
SIMV is a mix of PS with either PC or VC. The respiratory rate is usually set a little lower than in VC or PC, allowing spontaneous breaths to happen in between the mandatory/assisted breaths. This allows the ventilator to have a certain level of control, while allowing the patient some freedom to breathe spontaneously. This mode is most commonly seen in pediatrics. It can be used as a weaning mode, because weaning the set respiratory rate in spontaneous breathing patients slowly transitions from mostly PC/VC breaths to more PS breaths.
Pressure Control with Volume Guarantee (Pressure Regulated Volume Control / Adaptive Pressure Control)
“Volume Guarantee,” or “Adaptive Pressure Ventilation” is common mode of ventilation used in the ICU and OR. This is a form of Pressure Control that dynamically adjusts the set inspiratory pressure between breaths based on the previous measured tidal volumes to achieve the set, or “guaranteed” volume. This has the flow flexibility benefits of pressure control, while incorporating the consist ventilation of volume control. The downside is that as a patient puts more effort into their breathing, the ventilator will give them less help. The unintentional weaning this can do can be a cause of decompensation and must be closely monitored.
I really appreciate your videos as it is really important for Psychology students like us. Thank you 😊
Also, the ventilator connects to a high pressure non-humidified source of oxygen. You need to connect to the ventilator a means of providing humidification to the mixed gas in the ventilator circuit. It’s misleading to suggest a connection to a “humidified oxygen source” and the image you’re showing looks like either a bubble humidifier for low flow oxygen or a large volume nebulizer – neither are used in this case.
Your descriptions of ventilator modes need a lot of work and correction. The “Volume Control” mode you’re showing is PRVC, which is not a typical volume control mode. It doesn’t have a peak flow setting. Also, there is a trigger sensitivity setting for all synchronized ventilator modes, and all modes on modern ventilators are synchronized. The control breaths and pressure support breaths can both be triggered by the patient in SIMV. Also, that’s not how SIMV works at all. SIMV has a background set respiratory rate comprised of control breaths with set parameters like inspiratory time and either peak pressure or volume depending on the mode. If the patient breathes above the set rate, additional breaths will be pressure support breaths that have a set inspiratory pressure but a variable inspiratory time based on inspiratory flow. The description of giving more or less support based on how much a person is breathing is a better description of how PRVC works. PRVC is a pressure control mode that automatically adjusts the set pressure between breaths to target a set volume. This way, if a person breathes with more effort, the ventilator gives them less help, and vice versa. There is not a flow setting for pressure modes. I’ll come back to the synchronization and triggering. I can see where you might be confused, as old unsynchronized modes were called IMV, and you’d think adding synchronization to that would mean SIMV – unfortunately you’d be wrong. Control modes (volume or pressure) have trigger sensitivity and respiratory efforts are supported by the same breaths delivered on a timer based on the set respiratory rate.
Thanks 🇻🇳🇻🇳🇻🇳
Thank you Osmosis!
Wooooow !!!! Thaaaaaanks
You are the best of the best ❤❤❤🌺🌺🌸🌸🌸
Thanks a lot
Thanks for the continued great content!
👍👍👍👍
Second comment , thank you Osmosis
First here 😅
We’ve updated this video to clarify that ideal body weight should be used when calculating tidal volume, not actual weight. Using the latter could cause barotrauma to the patient.
@osmosis After the pulse oximetry video telling me I can just stick it across the forehead and then other commenters telling me that incorrect, I don’t know whether to believe the details anymore….