1. Pressure Regulated Volume Control Mode
FLIGHT MEDICAL
Pressure Regulated Volume Control Mode
PRVC
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2. Pressure Regulated Volume Control (PRVC)
Considered Dual Mode of Ventilation
Combines the advantages of both Volume Controlled & Pressure Controlled Ventilation
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3. 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
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4. PRVC Similar modes on other ventilator brands: Autoflow Drager Evita
Adaptive Support Hamilton Galileo
Volume Ventilation Plus Puritan Bennett 840
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5. 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.
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6. 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
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7. 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
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8. 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
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9. 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 cm H2o
High P alarm is both an alarm and a limit
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10. 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
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11. 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
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12. 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
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13. 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
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14. 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
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15. 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
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16. Setting Alarms in PRVC Alarm Screen
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17. Thank you