What are the disadvantages 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

A potential disadvantage of the assist-control mode is respiratory alkalosis in a small subset of patients whose respiratory drive supersedes the chemoreceptors and mechanical receptors. Patients with a potential for alveolar hyperventilation and hypocapnia in the assist-control mode include those with end-stage liver disease, those in the hyperventilatory stage of sepsis, and those with head trauma. These conditions are typically identified with the first arterial blood gas results, and the assist-control mode of ventilation can then be changed to an alternate mode.

Another possible disadvantage is the potential for serial preset positive-pressure breathes to retard venous return to the right side of heart and to affect global cardiac output. Nevertheless, the assist-control mode may be the safest initial choice for mechanical ventilation. It may be switched to another option if hypotension or hypocarbia are evident from the first arterial blood gas results.


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