Pressure modes of mechanical ventilation: the good, the bad, and the ugly.
Numerous pressure modes are currently available on ventilators. The application of microprocessor technology has resulted in sophisticated mode options that are very responsive to patient-initiated efforts, yet little is known about how to use the modes or their effect on patient outcomes. This article describes a wide variety of pressure modes including traditional modes such as pressure support and pressure-controlled ventilation in addition to less traditional new modes such as airway pressure release ventilation, biphasic positive airway pressure, Pressure Augmentation (Bear 1000, Viasys Healthcare, Yorba Linda, California), Volume Support (Maquet, Bridgewater, New Jersey), Pressure Regulated Volume Control (Maquet, Bridgewater, New Jersey), Volume Ventilation Plus (Puritan Bennett, Boulder, Colorado), Adaptive Support Ventilation (Hamilton Medical, Switzerland), and Proportional Assist Ventilation (Dräger Medical, Richmond Hill, Ontario, Canada). The "good, the bad, and the ugly" issues surrounding the application, evaluation, and outcomes of the modes are discussed.
Burns
Suzanne M
SM
Acute and Specialty Care Program, School of Nursing, University of Virginia Health System, Charlottesville, VA 22903, USA. smb4h@virginia.edu
D006801:Humans; D011312:Pressure; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*