prvc mode workshop
DESCRIPTION
PRVC Mode Workshop. Objectives. Understand the dual control concept Understand the pressure regulation mechanism in PRVC Demonstration of PRVC Settings and adjustment with Servo i and Dragger Indications, advantages and disadvantages. Volume vs Pressure Control. Dual Control Concept. - PowerPoint PPT PresentationTRANSCRIPT
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PRVC Mode Workshop
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Objectives
Understand the dual control concept Understand the pressure regulation
mechanism in PRVC Demonstration of PRVC Settings and adjustment with Servo i
and Dragger Indications, advantages and
disadvantages
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Volume vs Pressure ControlDual Control Concept
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Volume Control
Decreased Compliance
Maintained VT
Higher Pressure
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Pressure Control
Decreased Compliance
Lower VT
Same Pressure
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Dual Control
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PRVC Automatically Adjusts To Compliance ChangesPRESSURE CONTROL VENTILATION PRVC
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Pressure RegulationThe Concept
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PRVC
Assist-control ventilation Pressure control titrated to a set tidal
volume Time cycled
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Assist control
Breaths: Ventilator initiated (control breaths) Patient initiated (assist breaths) Set minimum frequency
Characteristics of each inspiration are the same Not affected by whether breath is control
breath or an assist breath
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Assist control
Set Minimum respiratory rate▪ Patient’s spontaneous respiratory rate < set
rate ventilator gives additional control breaths to make up difference▪ Patient’s spontaneous rate > set rate no
control breaths
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PRVC
Set Minimum respiratory rate Target tidal volume
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PRVC
Measure VT
Compareto set VT
Same inspiratorypressure
inspiratorypressure
inspiratorypressure
Test breath
Less
Equal
More
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PRVC
Set Minimum respiratory rate Target tidal volume Upper pressure limit:▪ Maximum delivered pressure = 5 cm H2O below
pressure alarm limit FIO2 Inspiratory time or I:E ratio Rise time PEEP
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Dual Control Breath-to-BreathPressure Regulated Volume Control
Control Trigger Limit Target CycleVolume Patient or
TimePressure Lowest
pressurefor set volume
Time
Pressure-limited Time-cycled Ventilation
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PRVC (Pressure Regulated Volume Control)
PRVC. (1), Test breath (5 cm H2O); (2) pressure is increased to deliver set volume; (3), maximum available pressure; (4), breath delivered at preset E, at preset f, and during preset TI; (5), when VT
corresponds to set value, pressure remains constant; (6), if preset volume increases, pressure decreases; the ventilator continually monitors and adapts to the patient’s needs
1 2 3 4 5 6
Upper Pressure Limit5 cm H2OPressure
Floe
Time
Time
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Volume fromVentilator=
Set tidal volume
Time= setInspiratory time
Pressure limitBased on VT/CTrigger Cycle off
Calculatecompliance
Calculate newPressure limit
no
yes
yes
no
Control logic for pressure-regulated volume control and autoflow
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PRVCThe Mode on Different Ventilators
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PRVC in Servo i
Pres
sure
Flow
Volu
me
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PRVC
Pres
sure
Flow
Volu
me
Upper Pressure limit5 cm H2O
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Pressure Regulation in Drager
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Pressure Regulation in CMV
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Pressure Limit in Autoflow
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PRVCIndications, Advantages and Disadvantages
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Advantages
Decelerating inspiratory flow pattern Pressure automatically adjusted for
changes in compliance and resistance within a set range Tidal volume guaranteed Limits volutrauma Prevents hypoventilation
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Disadvantages
Pressure delivered is dependent on tidal volume achieved on last breath Intermittent patient effort variable
tidal volumes Less suitable for patients with
asthma or COPD
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PRVC (Pressure Regulated Volume Control) DISADVANTAGES AND RISKS
Varying mean airway pressure
May cause or worsen auto-PEEP
When patient demand is increased, pressure level may diminish when support is needed
May be tolerated poorly in awake non-sedated patients
A sudden increase in respiratory rate and demand may result in a decrease in ventilator support
AFVANTAGES
Maintains a minimum PIP Guaranteed VT Patient has very little WOB
requirement Allows patient control of
respiratory rate Decelerating flow waveform
for improved gas distribution Breath by breath analysis
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Thank You