Pressure Regulated Volume Control Mode FLIGHT MEDICAL Pressure Regulated Volume Control Mode PRVC Confidential

Pressure Regulated Volume Control (PRVC) Considered Dual Mode of Ventilation Combines the advantages of both Volume Controlled & Pressure Controlled Ventilation Confidential

Pressure Regulated Volume Control In PRVC ventilator will attempt to deliver desired set tidal volume (Vt) using the lowest possible pressure PRVC available in ACMV & SIMV Use clinically as you would standard volume control Confidential

PRVC Similar modes on other ventilator brands: Autoflow Drager Evita Adaptive Support Hamilton Galileo Volume Ventilation Plus Puritan Bennett 840 Confidential

PRVC How does PRVC work When switching to PRVC mode the ventilator first delivers a set of volume ‘test’ breaths to determine lung compliance and the necessary pressure required to deliver the targeted volume. Note: this is also done anytime ventilation is interrupted. i.e. suctioning, opening the circuit, etc. Confidential

PRVC Pressures are then adjusted breath by breath, regulating the amount of pressure needed to achieve set Vt Maximum change in pressure per breath +/- 3 cm H2o. Therefore, achieving target Vt is accomplished over a number of breaths +/- 10% of set Vt Confidential

PRVC FLOW CHART Test Breath Measured Vt Less than set Vt More than Compare to Set Vt Equal Decrease Inspiratory Pressure Increase Inspiratory Pressure Ventilator regulates the amount of pressure needed to obtain desired set volume. It will increase or decrease amount of pressure on breath by breath basis +/- 3 cm H2o Give same Insp pressure Confidential

PRVC Clinical Advantages and Disadvantages Advantages of PRVC ‘Guarantees’ delivery of Vt Minimizes risk of barotrauma due to increased peak pressures Decelerating flow pattern may provide better distribution of ventilation & oxygenation Can better meet inspiratory flow demands Improved oxygenation is a benefit of PRVC as well as reduced incidence of atelectasis Confidential

PRVC Clinical Advantages and Disadvantages Disadvantages of PRVC -Ventilator may potentially increase pressures to higher than desired levels in an attempt to deliver set Vt. Set appropriate High P alarm Typical setting 35-40 cm H2o High P alarm is both an alarm and a limit Confidential

PRVC Clinical Advantages and Disadvantages Disadvantages of PRVC modality It takes a number of ventilator delivered breathes to achieve set Vt; therefore if the patient coughs a lot / fighting the ventilator / a lot of suctioning they will likely not receive set Vt during these events Confidential

How to set up PRVC on the Flight 60 In PRVC the following breath controls are required: Target VCV (This is the target tidal volume) Rate: Breath Rate Ti Inspiratory Time The maximum airway pressure never exceeds the set high pressure (High P) alarm limit Confidential

How to set up PRVC on the Flight 60 PRVC is available in ACMV & SIMV modes To set the PRVC sub-mode of ventilation 1. Tap the sub-modes control button 2. Select PRVC & press Enter Sub modes button depressed in photo to show PRVC option Confidential

Parameters to set in PRVC Trigger- pressure or flow Peep PSV above peep – minimum applied pressure to support a breath Ti – Inspiratory time VCV – Target tidal volume Modes: ACMV/SIMV Sub mode: PRVC Fio2 % / 100% o2 Alarm button Confidential

How to set up PRVC on the Flight 60 Trigger/ Peep /Pressure Support above peep/rate/ Ti/ VCV (target Vt)/ fio2/mode/submode/Pressure support above peep= minimum pressure used to support breath Confidential

Setting Alarms in PRVC High rate / Low rate Low Vte / Low Vti Apnea Interval Low / High MV Low / High Fio2 P High – *Pressure Limit, alarm P Low - * Pressure Limit, alarm Confidential

Setting Alarms in PRVC Alarm Screen Confidential

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