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Don appropriate personal protective equipment (PPE) based on the patient’s signs and symptoms and indications for isolation precautions.
Ventilator failure or accidental disconnection can be catastrophic in patients undergoing neuromuscular blockade.
Pressure-regulated volume control (PRVC) ventilation is a mode designed for invasive mechanical ventilation that combines volume and pressure strategies. PRVC delivers a pressure-controlled and tidal volume (VT)-targeted breath using a decelerating flow waveform pattern that allows unrestricted spontaneous breathing with or without pressure support (PS). Setting options, terminology, and abbreviations may be brand specific based on the mechanical ventilator specifications.undefined#ref2">2
PRVC is considered an advanced dual control or adaptive mode because the ventilator uses both volume and pressure to automatically adjust to the patient’s ventilatory needs.1 Pressure, flow, or volume delivery depends on variables such as lung compliance, airway resistance, and respiratory effort.4 The mechanical ventilator delivers the lowest pressure and appropriate flow to meet the set VT target for each delivered breath.1,3 A mandatory rate is set for the patient. The patient may breathe above the set rate. All breaths are patient triggered or time triggered. The ventilator compares volume and pressure values from the previous breath and increases or decreases pressure levels according to tidal or minute ventilation. The pressure level that is delivered is between the set positive end-expiratory pressure (PEEP) and the set upper pressure limit. If the measured volume either increases or decreases above or below the settings, the pressure decreases or increases accordingly in small increments to a maximum determined by the type of ventilator. The pressure available to achieve the targeted volume is generally 5 cm H2O below the set upper pressure limit.1 If this set pressure limit is reached, the ventilator breath is terminated, the pressure limit alarm will sound, and the patient will receive as much of the set volume as possible given the pressure limit. The ventilator adjusts accordingly for the next delivered breath.
PRVC is a lung protective strategy that helps to meet the goals of acute respiratory distress syndrome (ARDS) management, maximizing inspiratory flow needs for improved patient comfort, ventilatory synchrony, and minimizing the risk of barotrauma and volutrauma.1,4 PRVC may be used for the adult, pediatric, and infant populations. If the patient’s lung compliance decreases or airway resistance increases, the system flow and pressure increases. If lung compliance increases or airway resistance decreases, the system flow and pressure decreases. PRVC provides the comfort and safety of pressure ventilation for patients of all ages with a target VT and minute ventilation.
Setting options, terminology, and abbreviations may be brand specific based on trademarked mechanical ventilator specifications.
The patient may breathe above the set respiratory rate.
If the measured volume either increases or decreases above or below the settings, the pressure decreases or increases accordingly in small increments to a maximum determined by the type of ventilator.
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