Controlled Mechanical Ventilation

Abstract

The goal of mechanical ventilation is to achieve adequate gas exchange, while minimizing haemodynamic compromise and ventilator-associated lung injury (VALI). There are a vast and ever increasing number of ventilator modes and settings to choose from. After endotracheal intubation, the first choice facing the clinician is between two basic modes of mechanical ventilation—pressure- and volume-controlled. In pressure control mode, peak inspiratory pressure is selected and tidal volumes are variable. In volume control mode, tidal volume is guaranteed at the expense of variable airway pressures. Volume-controlled ventilation, (also termed volume-cycled or volume-limited) can be delivered via several modes including controlled mechanical ventilation (CMV), assist control (AC) and synchronized intermittent mandatory ventilation (SIMV).