1. Intermittent Mandatory Ventilation IMV RC 270

2. IMV is a technique which allows the patient to breathe spontaneously (setting his own Vt and rate) with supplemental O2 and to periodically get a specific number of positive pressure breaths from the ventilator. Its like being on a T-tube and the ventilator at the same time

3. Ex. #1 : IMV of 8, Vt=900 ml Eight times a minute the patient gets a 900 ml positive pressure breath from the ventilator. In between the positive pressure breaths, he breathes spontaneously at his own rate and Vt.

4. Indications/Advantages for IMV  Weaning –Using IMV to wean is no faster or better than classical weaning or any other mode  Controlling PaCO2 –IMV Ve is titrated with patient’s spontaneous Ve –Often done with neuro patients  To get a lower mean intrathoracic pressure than A/C

7. Most ventilators incorporate a demand system for IMV that allows the patient access to source gas at the rate, flow, and volume, that the patient demands.

8. INITIATING IMV  If starting with IMV, set IMV Ve as you would back-up Ve for A/C  If switching to IMV from A/C, set IMV Ve to about one half of the patient’s OBSERVED Ve when he was on A/C  Titrate IMV Ve based on ABGs and patient’s spontaneous Ve