Volume Assist/Control Mechanical Ventilation
How does this mode work?
• Delivers a set volume of air with each breath; patient triggered breaths are identical to machine triggered breaths
• Time and patient triggered, volume cycled, volume limited mode
When should I use this mode?
• Ensures that a patient receives a minimum MV
• This is a good general-purpose mode; good for providing Lung Protective Ventilation (LPV)
• PRVC mav have lower peak pressures; pressure modes may be more comfortable for select patients
What do I need to monitor?
• Need to make sure the peak pressure and plateau pressure do not exceed safe limits.
• You will also need to monitor MV. If the patient is triggering excessively (or auto-triggering), they can become alkalemic.
Choosing Initial Settings:
• RR - Try to match the persons initial minute ventilation by selecting a rate to match their pre-intubation MV needs.
• TV- Use 8cc/kg PBW and adjust as needed. For patients with ARDS (or at high risk) consider starting at 6cc/kg PBW.
• Start with low PEEP and high Fi02 and wean to maintain SpO2 goal (typically > 90%).
- Nick Mark MD @nickmmark
#volume #assistcontrol #mechanical #ventilation #AC #criticalcare #pulmonary