Assist control (AC) and synchronized intermittent mandatory ventilation (SIMV) modes 

Also keep in mind Simv comes with pressure support which will help spontaneous breaths.

In assist control mode.... There's a high chance of hyperventilating//

also u can have SIMV +PS so any effort done by the patient to trigger the inspiration he will not fully depending on his muscle power he will get the amount of support you set in term of pressure and u can start with high PS to correlate the measuring exhaled tidal volume of his effort to your set mandatory tidal volume and gradually decrease the support so u can exercise his respiratory muscles until u reach 0 support and then decrease your set respiratory rate of mandatory tidal volume and the end extubate your patient. from all of these features mentioned above Assist Control mode from my opinion should not be used anymore as initial setting

@@emadalmehmal8781 do you mean the users will have breathing support such as volume, PS set according to the setting in simv mode when they trigger inspiration?

Exactly already the mandatory required minute ventilation is already set in SIMV, so no qquestion of hypoventilation

:)

Asma Al Sheikh make sure patient is receiving adequate humidification.

The mucous plug was increasing the pressure due to resistance and the patient could not receive the tidal volume.

place fisher pykel, regular salbutamol nebs. if there is air trapping alongside increased Rinsp then decreasing airway resistance is warranted

which the mucous plug and thick secretions being the main problem and cause of ventilation difficulties

Ç

Yes I thought so too, and my book says so as well. In an other video they mentioned the Vt was set in AC and SIMV mode but only in SIMV mode the patient is allowed to breathe above that set rate (for example 500cc). But it will always be at least 500cc in SIMV then.

Patients can breathe above set rate in both AC and SIMV mode. However, in SIMV mode, when a patient triggers a breath the machine will give a spontaneous breath (with Pressure Support, if set). Whereas in AC mode, the machine will give a full machine breath (the Vt you have set) when triggered. I am a little bothered by this video because the narrative is slightly slanted Pro-AC vs SIMV. Both modes are great, and neither one is necessarily better than the other. There are even times when the modes are EXACTLY the same... so as you progress in your career, you'll understand what I mean when I tell my students to "Not be a Mode Bigot". Ventilator modes are all "Tools" of the trade. Each patient is different, and each situation has a slightly better "Tool" for the job. I can tell you there are some instances where SIMV is superior to AC (particularly when the tidal volume and rate are not set ideally for a patient's demand, which actually happens more often than folks think). Good luck to you in your studies.

Just depends on what you're trying to achieve. SIMV is great for trying to wean a patient while AC is primarily used to allow the patient to rest but also trigger their own breaths. This works great because you can tell your patient is becoming active and then you could switch to SIMV mode to help wean that patient down while offering some support.

I guess some ventilators do. Well, I'm not totally sure, but I guess Servo does some thing like that!

no because the vent will recognize that the patient took a breath and it will count in its set RR of 15

T Sqz i think the back up mode adjust when the patient’s breath triggers.

Jeremy Normann aadarsha

The respiratory rate is always set according to patient demands, moreover, other measures like tidal value and FIO2 are intended to rich the best oxygenation and co2 elimination, which is the main goal in every respiratory care. Sometimes you have the option to use on-tube capnography on you're patient, as well as the spo2, just to make sure you provide the best gas diffusion and prevent hyperventilation and all the related complications associated with. I hope you find it helpful :)