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
