What are the advantages of assist-control mechanical ventilation?

Updated: Apr 11, 2019
  • Author: Christopher D Jackson, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

After deciding to start positive-pressure ventilation with a volume-cycled ventilator, the clinician must now select the safest initial mode of machine operation.

In most circumstances, the initial mode of ventilation should be the assist-control mode, in which a tidal volume and rate are preset and guaranteed. The patient can affect the frequency and timing of the breaths. If the patient makes an inspiratory effort, the ventilator senses a decrease in the circuit pressure and delivers the preset tidal volume. In this way, the patient can dictate a comfortable respiratory pattern and may trigger additional machine-assisted breaths above the set rate. If the patient does not initiate inspiration, the ventilator automatically delivers the preset rate and tidal volume, ensuring minimum minute ventilation. In the assist-control mode, the work of breathing is reduced to the amount of inspiration needed to trigger the inspiratory cycle of the machine. This trigger is adjusted by setting the sensitivity of the machine to the degree of pressure decrease desired in the circuit (see image below).

The pressure, volume, and flow to time waveforms f The pressure, volume, and flow to time waveforms for assist-control ventilation.

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