Modes of Ventilation: Types and Uses

Ventilation is the air movement between the environment and the lungs via inhalation and exhalation. Mechanical ventilation using artificial methods to assist breathing 

1. CMV (Controlled Mode Ventilation) also known as IPPV (intermitted positive pressure ventilation)
2. SIMV (Synchronized Intermittent Ventilation)
3. PCV- Pressure Control Ventilation
4. PS- Pressure Support
5. CPAP- Continuous Positive Airway Pressure 

Modes of ventilation is one of the most important aspects of using mechanical ventilation. The mode refers to the method of inspiratory support. Mechanical ventilation machines are available with invasive and non-invasive modes.

Read this blog further to get a quick overview of this important topic for DERMATOLOGY and gynaecology and ace your NEET PG exam preparation.

Types of Modes of Ventilation

Mode of ventilation	Controlled mode ventilation (CMV)	Synchronized intermittent mode ventilation(SIMV)	Pressure control ventilation (PCV)	Ps-pressure support	Continuous positive airway pressure(CPAP)
Physical character	The patient's weight is 50kg	RR 14/min	Pressure is being controlled	Spontaneous breathing	PEEP +CPAP
Tidal volume	Tidal Volume 7-8 ml/kg	Tidal Volume 400ml/kg	Not a weaning mode	Works on two mechanisms	It enables the alveoli to be open
Patient efforts	No efforts from the patient's side	Less V/Q mismatch	Less protective ventilation	CPAP	To improve the oxygenation
Usage	Heavily sedated	No/slight sedation	Pediatric	BIPAP	Decrease in bp and urine output

CMV (Controlled Mode Ventilation)

Control ventilation is a mode of ventilation in which the respirator delivers the preset volume or pressure regardless of the patient's inspiratory efforts. It is indicated in patients with severe neurological alterations, deep sedation, shock, or respiratory failure.

Feature	To avoid any kind of synchrony
The patient weighs 50kg.	V/Q is mismatched.
Tidal volume is 7-8 ml/kg.	There is more hemodynamic imbalance.
There is no effort from the patient's side.	It is not a weaning mode.
The patient is heavily sedated/paralyzed.	It is used for a patient under general anesthesia.

SIMV (Synchronized Intermittent Mode of Ventilation)

Synchronized intermittent mandatory ventilation is a ventilator mode that enables partial mechanical assistance. This ventilator mode will provide a set number of breaths at a fixed tidal volume, but a patient can trigger a spontaneous breath with the volume determined by patient effort.

Graph description:

The patient's tidal volume is 400 ml, as shown in the 1st slope of the graph. 2nd slope of the graph represents If the patient breathes only 250 ml, the ventilator will provide an additional 150 ml to make it 400 ml of tidal volume.

Feature	Avoid any synchrony
The tidal volume of the patient is 400ml/kg	There is less V/Q mismatch.There is less hemodynamic imbalance.
The respiratory rate of the patient is 14/min	No/slight sedation is required.
The Patient and the ventilator are working in synchrony.	It is a weaning mode.

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Pressure Control Ventilation (PCV)

Pressure-controlled ventilation is utilized in patients with an indwelling endotracheal tube or tracheostomy tube that affords the practitioner the ability to ventilate a patient with a maximal peak pressure.

Features	Used in
The Pressure is being controlled.	ARDS.
The Upper limit of intra-alveolar pressure is fixed.	Pediatric.
It is not a weaning mode.
It is a Lung protective ventilation.

PS Ventilation

Pressure support ventilation (PSV) is a spontaneous mode of ventilation in which each breath is initiated by the patient but is supported by constant pressure inflation. The person is spontaneously breathing. It works on two mechanisms. CPAP-continuous positive airway pressure. PEEP- positive end-expiratory pressure = Enables the alveoli to open.

PEEP (Positive End-Expiratory Pressure)

It enables the alveoli to be open at the end-expiration. It helps To improve the oxygenation of the patient. An increase in intrathoracic pressure leads to a decrease in venous pressure and a decrease in CO₂ . BP is a decrease in the perfusion of a vital organ. A decrease in urine output.

CPAP(Continous Positive Airway Pressure)

CPAP is frequently used to evaluate a patient's chances of being extubated if they only need little ventilation support. It maintains the circuit pressure that the operator specifies throughout ventilation. PS is frequently combined with CPAP.

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