6.0 Chapter Overview

We have now overviewed control modes of ventilation and talked about when and how to control a patient’s breathing. In previous chapters, we discussed how spontaneous modes allow a patient to be much more in control of their breathing, including how often they breathe and how big a breath they take. In this chapter, we will look more closely at spontaneous modes.

This chapter covers:

• Spontaneous modes: Overview and description of pressure support ventilation (PSV), volume support (VS) and other spontaneous modes
• When we use spontaneous modes
• Spontaneous modes settings
• How we choose the correct settings when initiating spontaneous modes
• Review of SIMV, in the context of spontaneous breathing, and why it is not a preferred mode

Application

As we have already learned, spontaneous modes are used whenever a patient has an intact drive to breathe because spontaneous ventilation helps to avoid muscle wastage and asynchrony. This chapter will help you to use spontaneous mode effectively, including choosing appropriate ventilator settings. In addition, this chapter describes Synchronized Intermittent Mandatory Ventilation (SIMV), which was once the preferred approach to ventilation, and explains why it is not used in typical ventilation practice today. Since SIMV is still used by some healthcare centers, it is important that you are aware of this mode and the reasons that it is no longer used so that you are well positioned to advocate for your patients.

“Chapter 6 | Spontaneous Modes and SIMV” from Basic Principles of Mechanical Ventilation by Melody Bishop, © Sault College is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.