Intermittent mandatory ventilation

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Intermittent Mandatory Ventilation (IMV) is a mode of mechanical ventilation used in critical care medicine. It is designed to provide a combination of mandatory breaths and spontaneous breaths to patients who are unable to maintain adequate ventilation on their own.

Mechanism

IMV allows the patient to breathe spontaneously between the mandatory breaths delivered by the ventilator. The mandatory breaths are delivered at a set respiratory rate, tidal volume, and inspiratory time. This mode of ventilation is beneficial for patients who have some respiratory drive but need assistance to maintain adequate alveolar ventilation.

Types

There are two main types of IMV:

  • Synchronized Intermittent Mandatory Ventilation (SIMV): In this mode, the ventilator synchronizes the delivery of mandatory breaths with the patient's spontaneous breathing efforts. This synchronization helps to improve patient comfort and reduce the work of breathing.
  • Non-Synchronized Intermittent Mandatory Ventilation: In this mode, the ventilator delivers mandatory breaths at preset intervals, regardless of the patient's spontaneous breathing efforts.

Indications

IMV is indicated in patients who require partial ventilatory support. It is commonly used in the following situations:

  • Weaning from mechanical ventilation
  • Patients with respiratory failure who have some spontaneous breathing ability
  • Post-operative patients who need temporary ventilatory support

Advantages

  • Allows for spontaneous breathing, which can help maintain respiratory muscle strength
  • Can be used as a weaning mode to transition patients off mechanical ventilation
  • Provides a balance between mandatory and spontaneous breaths

Disadvantages

  • May lead to asynchrony between the patient and the ventilator if not properly synchronized
  • Requires careful monitoring and adjustment to ensure adequate ventilation

See also

References



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