Intermittent mandatory ventilation

Intermittent Mandatory Ventilation

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A diagram showing the process of Intermittent Mandatory Ventilation

Intermittent Mandatory Ventilation (IMV) is a mode of mechanical ventilation that is used in the intensive care unit (ICU) to assist patients who are unable to breathe adequately on their own. IMV provides a preset number of breaths per minute, allowing the patient to breathe spontaneously in between the mandatory breaths.

Overview

IMV was first introduced in the 1970s as a method of weaning patients from mechanical ventilation. It is designed to allow the patient's respiratory muscles to work in between the mandatory breaths, which can help to prevent muscle atrophy and promote more natural breathing patterns.

Mechanism

In IMV, a certain number of breaths are delivered at a preset volume or pressure, regardless of the patient's own breathing efforts. The patient is then free to breathe spontaneously in between these mandatory breaths. The ventilator does not synchronize with the patient's own breaths, which distinguishes IMV from other modes of ventilation such as Synchronized Intermittent Mandatory Ventilation (SIMV).

Clinical Use

IMV is often used in the initial stages of mechanical ventilation, when the patient's respiratory system is too weak to sustain adequate ventilation on its own. It can also be used as a weaning method, gradually reducing the number of mandatory breaths as the patient's condition improves.

Advantages and Disadvantages

The main advantage of IMV is that it allows the patient's respiratory muscles to remain active, which can help to prevent muscle atrophy. However, because the ventilator does not synchronize with the patient's own breaths, there can be a risk of breath stacking or auto-PEEP, which can increase the work of breathing and potentially lead to barotrauma.

See Also

• Mechanical ventilation
• Synchronized Intermittent Mandatory Ventilation
• Positive end-expiratory pressure
• Ventilator-associated pneumonia