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APVcmv stands for adaptive pressure ventilation with controlled mandatory ventilation. On some devices, this mode is also called (S)CMV+, which stands for synchronized controlled mandatory ventilation.

APVcmv is a volume-targeted pressure-controlled ventilation mode. It functions similarly to the conventional volume-controlled mode of ventilation, (S)CMV, except that pressure is the control variable rather than flow. Pressure is adjusted between breaths to achieve the target tidal volume. The breath can be triggered by the ventilator or by the patient. If the breath is triggered by the patient, the inspiratory rate may increase.

The ventilator uses the high Pressure alarm limit minus 10 cmH2O as a safety boundary for its inspiratory pressure adjustment, and does not exceed this value. An exception is sigh breaths, when the ventilator may apply inspiratory pressures 3 cmH2O below the high Pressure alarm limit. Breaths in APVcmv mode are volume-targeted and mandatory, delivered at the lowest possible pressure depending on lung conditions.

The operator sets the target tidal volume (Vt). The ventilator delivers the set target volume (Vt) at a preset rate. The patient can trigger mandatory breaths between preset rate breaths.

Control parameters for APVcmv or (S)CMV+:

APVsimv stands for adaptive pressure ventilation with synchronized intermittent mandatory ventilation. This mode is also called SIMV+, synchronized intermittent mandatory ventilation plus. The APVsimv mode combines attributes of the APVcmv and SPONT modes, delivering volume-targeted mandatory breaths or pressure-supported spontaneous (patient-triggered) breaths.

APVsimv mode ensures that the set target volume is delivered during the mandatory breaths. After the mandatory breath is delivered, the patient is free to take any number of spontaneous breaths for the remainder of the APV breath interval.

The ventilator uses the Plimit setting (On supported devices. Devices without the Plimit parameter use the highPressure alarm limit minus 10 as the safety boundary.c​) (high Pressure alarm limit minus 10 cmH2O) as a safety boundary for its inspiratory pressure adjustment, and does not exceed this value. An exception is Sigh breaths, when the ventilator may apply inspiratory pressures 3 cmH2O below the high Pressure alarm limit.

Each breath interval includes mandatory time (Tmand) and spontaneous time (Tspont).

• If the patient triggers a breath during Tmand, the ventilator immediately delivers a mandatory breath.
• If the patient triggers a breath during Tspont, the ventilator delivers a spontaneous pressure-supported breath.

If the patient does not trigger a breath during Tspont, the ventilator automatically delivers a mandatory breath at the end of Tmand.

In this mode, parameters for both mandatory and spontaneous breath types are set.

• The tidal volume (Vt) setting defines the delivered volume of mandatory breaths.
  Rate and I:E (Depending on the selected breath timing philosophy (I:E, TI, or other supported option, if available).b​) define the timing of the breath cycle for mandatory breaths.
• For spontaneous breaths, Psupport (On some devices, ΔPsupport.d​) defines the pressure support above PEEP.
  ETS defines the inspiratory timing of the breaths. The inspiratory time can also be limited by TI max (On some devices, TI max is only available for adult/pediatric patients if it is enabled in Configuration. It is always available for neonates.e​).

Control parameters for APVsimv or SIMV+:

VS stands for Volume Support ventilation.

Breaths in VS mode are volume-targeted and spontaneous. Pressure is adjusted between breaths to achieve the target tidal volume. The ventilator uses the Plimit (On supported devices. Devices without the Plimit parameter use the highPressure alarm limit minus 10 as the safety boundary.c​) setting (high Pressure alarm limit minus 10 cmH2O) as a safety boundary for its inspiratory pressure adjustment, and does not exceed this value. An exception is Sigh breaths, when the ventilator may apply inspiratory pressures 3 cmH2O below the high Pressure alarm limit.

To achieve the set tidal volume, the device decreases support when the patient’s breathing activity increases, and conversely, increases support when the patient’s inspiratory efforts decrease. In this mode, the patient initiates all breaths.

• The tidal volume (Vt) setting defines the delivered volume.
• The P-ramp setting controls the speed with which the ventilator arrives at the desired pressure.
• ETS defines the inspiratory timing of the breaths. The inspiratory time can also be limited by TI max (On some devices, TI max is only available for adult/pediatric patients if it is enabled in Configuration. It is always available for neonates.e​).

Control parameters for VS:

(S)CMV stands for synchronized controlled mandatory ventilation.

Breaths in (S)CMV mode are volume-controlled and mandatory. The breath can be triggered by the ventilator or by the patient. If the breath is spontaneous (triggered by the patient), the inspiratory rate may increase.

If a breath is not triggered by patient effort within a preset time, the ventilator delivers a set tidal volume with a constant flow or operator-selected flow pattern for a set inspiratory time at a set respiratory rate. The ventilator always delivers the set tidal volume; pressure in the airway can increase or decrease depending on the resistance and compliance of the patient’s lungs. To protect the patient’s lungs it is important to carefully set an upper pressure limit.

Control parameters for (S)CMV:

SIMV stands for synchronized intermittent mandatory ventilation.

The SIMV mode combines attributes of the (S)CMV and SPONT modes, delivering volume-controlled mandatory breaths or pressure-supported spontaneous (patient-triggered) breaths. SIMV mode ensures that the set target volume is delivered during the mandatory breaths. After the mandatory breath is delivered, the patient is free to take any number of spontaneous breaths for the remainder of the SIMV breath interval.

Each SIMV breath interval includes mandatory time (Tmand) and spontaneous time (Tspont). If the patient triggers a breath during Tmand, the ventilator immediately delivers a mandatory breath. If the patient triggers a breath during Tspont, the ventilator delivers a spontaneous, pressure-supported breath.

If the patient does not trigger a breath during Tspont, the ventilator automatically delivers a mandatory breath at the end of Tmand. In SIMV mode, parameters for both the mandatory and spontaneous breath types are set.

• The tidal volume (Vt) setting defines the delivered volume of mandatory breaths.
• Rate and I:E (Depending on the selected breath timing philosophy (I:E, TI, or other supported option, if available).b​) define the timing of the breath cycle.
• Psupport (On some devices, ΔPsupport.d​) defines the pressure support above PEEP.
• For spontaneous breaths, the expiratory trigger sensitivity (ETS) setting defines the percentage of peakflow that cycles the ventilator into exhalation.

Control parameters for SIMV:

PCV+ stands for pressure-controlled ventilation.
Breaths in PCV+ mode are pressure controlled and mandatory. The ventilator delivers a constant level of pressure, so the volume depends on the pressure settings, the inspiration time, and the resistance and compliance of the patient’s lungs.In PCV+ mode, parameters are set only for mandatory breaths.

This mode is available for use with a speaking valve on supported devices.

Control paremeters for PCV+ or P-CMV:

PSIMV+ stands for pressure-controlled synchronized intermittent mandatory ventilation. PSIMV+ mode has two options: with and without PSync.

In PSIMV+ mode, the mandatory breaths are PCV+ breaths. These can be alternated with spontaneous breaths. Each SIMV breath interval includes mandatory time (Tmand) and spontaneous time (Tspont).

• If the patient triggers a breath during Tmand, the ventilator immediately delivers a mandatory breath.
• If the patient triggers a breath during Tspont, the ventilator delivers a spontaneous, pressure-supported breath.

If the patient does not trigger a breath during Tspont, the ventilator automatically delivers a mandatory breath at the end of Tmand. In PSIMV+ mode, parameters for both mandatory and spontaneous breath types are set.

• For mandatory breaths, the pressure control (Pcontrol (On some devices, ΔPcontrol.g​)) setting defines the applied pressure above PEEP.
  Rate and I:E define the timing of the breath cycle.
• For spontaneous breaths, Psupport (On some devices, ΔPsupport.d​) defines the pressure support above PEEP.
  ETS defines the inspiratory timing of the breaths. On some devices, the inspiratory time can also belimited by TI max (On some devices, TI max is only available for adult/pediatric patients if it is enabled in Configuration. It is always available for neonates.e​).

This mode is available for use with a speaking valve.

Control parameters for PSIMV+ or P-SIMV:

SPONT stands for spontaneous mode.

SPONT delivers spontaneous breaths and operator-initiated manual, mandatory breaths. When pressure support is set to zero, the ventilator functions like a conventional CPAP system.

• The pressure support (Psupport (On some devices, ΔPsupport.d​)) setting defines the applied pressure during inspiration.
• The PEEP setting defines the PEEP applied during expiration.
• ETS defines the inspiratory timing of the breaths.
  The inspiratory time can also be limited by TI max.

This mode is available for use with a speaking valve on supported devices.

Control parameters for SPONT:

DuoPAP stands for duo positive airway pressure.

DuoPAP is a type of pressure ventilation designed to support spontaneous breathing on two alternating levels of CPAP. In this mode, the ventilator switches automatically and regularly between two operator-selected levels of positive airway pressure or CPAP.

Cycling between the levels is triggered by DuoPAP timing settings or by patient effort. In DuoPAP, the switch-over between the two levels is defined by the pressure settings, P high and PEEP/CPAP, and the time settings, T high and Rate. Note the following:

• At conventional settings and in the absence of spontaneous breathing, DuoPAP resembles PCV+.
• As you decrease the rate, keeping T high short relative to the time at the lower pressure level, the modelooks more like PSIMV+, with spontaneous breaths following mandatory breaths.
• If T high is set to almost the breath cycle time with just enough time at the low level to allow full or near-full exhalation, this mode looks like APRV.

Pressure support can be set to assist spontaneous breaths in DuoPAP, whether they occur at the PEEP/CPAP or P high level. Psupport (On some devices, ΔPsupport.d​) is set relative to (above) PEEP/CPAP, which means that spontaneous breaths at the P high level are supported only when this target pressure is greater than P high.

Control parameters for DuoPAP:

APRV stands for airway pressure release ventilation.

Set airway pressure P high is transiently released to a lower level P low, after which it is quickly restored to reinflate the lungs. For a patient who has no spontaneous breathing efforts, APRV is similar to pressure-controlled inverse ratio ventilation. APRV allows spontaneous breathing at any time during the respiratory cycle. APRV is an independent mode. When changing modes, the pressure and timing settings from any other mode are not transferred to APRV, and vice versa.

When switching to APRV for the first time, the initial timing and pressure settings proposed are based on IBW (Weight for neonatal patients) as shown in the following table.

Control parameters for ARPV:

Find out more about ASV.

Control parameters for ASV:

Find out more about INTELLiVENT-ASV.

Control parameters for INTELLiVENT-ASV:

NIV stands for noninvasive ventilation.

NIV mode delivers spontaneous breaths. NIV is designed for use with a mask or other noninvasive patient interface. When pressure support is set to zero, the ventilator functions like a conventional CPAP system.

• The pressure support (Psupport (On some devices, ΔPsupport.d​)) setting defines the applied pressure during inspiration.
• ETS defines the inspiratory timing of the breaths.
  The inspiratory time can also be limited by TI max.
• The PEEP setting defines the PEEP applied during expiration.

Control parameters for NIV:

NIV-ST stands for spontaneous/timed noninvasive ventilation.

NIV-ST mode delivers time-cycled or flow-cycled breaths. Every patient trigger results in a flow-cycled, pressure-supported breath. If the rate of patient-triggered breaths falls below the set mandatory Rate, time-cycled breaths are delivered at the set Rate and timing. If the patient triggers a breath during the breath interval timv, the ventilator immediately delivers a spontaneous breath. If the patient does not trigger an inspiration during this time, the ventilator initiates a mandatory breath at the end of timv.
When pressure support is set to zero, the ventilator functions like a conventional CPAP system. This mode requires that you set the parameters needed for both mandatory and spontaneous breath types.

The inspiratory pressure setting, Pinsp (On some devices, ΔPinsp.k​), defines the applied pressure for both mandatory and spontaneous breaths. The Rate and TI (inspiratory time) control settings define the breath timing. For spontaneous breaths, the ETS setting defines the percentage of peak flow that cycles the device into exhalation. The inspiratory time can also be limited by TI max.

Control parameters for NIV-ST:

High flow nasal cannula therapy (Also known as high flow oxygen therapy. This terminology can be used interchangeably with high flow nasal cannula therapy.l​) is indicated for adult, pediatric, and neonatal patients who are able to inhale and exhale spontaneously. HiFlowO2 (On some devices, Hi Flow O2.m​) is an optional therapy in which a continuous flow of heated and humidified respiratory gases are delivered to the patient. An operating humidifier is required.
The operator sets the oxygen and flowrate. If a flow sensor is connected, the airway pressure is monitored.

Depending on the circuit and interface resistance, higher pressures may be required to deliver the set flow. Pressure is measured inside the ventilator. This respiratory support is usually delivered through a nasal cannula, with the flow exceeding the patient’s peak inspiratory flow to provide inspired oxygen of up to 100%.

High flow oxygen therapy can be delivered using single or double limb breathing circuits, using a high-flow nasal cannula or a tracheal adapter/tracheal mask to enable the patient to exhale. Note that during high flow oxygen therapy, disconnection and apnea alarms are inactive.

Control parameters for HiFlowO2: