Q How can I and my colleagues ensure we are using new mechanical ventilator modes the most effective way?

A John J. Gallagher, DNP, RN, CCNS, CCRN-K, TCRN, RRT, replies

Modern mechanical ventilators have modes previously unavailable when mechanical ventilation was first established as a support therapy more than 50 years ago. Regardless of the manufacturer trade names assigned to these modes, all modes fall into 1 of 2 categories: volume control and pressure control. In volume-control mode, a flow of gas is delivered to achieve a set volume (ie, tidal volume [Vt]) with each ventilator breath. Although the set Vt may be guaranteed with each breath, the pressure generated in the pulmonary system varies depending on airway resistance, lung compliance, and lung elastance. Pressure-control modes deliver a flow of gas to achieve a set inspiratory pressure. In these modes, Vt may vary depending on airway resistance, lung compliance,...

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