Illustration of Adaptive Targeting Scheme on APV

Watching an adaptive mode titrate inspiratory pressure breath by breath to reach the target tidal volume.

APVMechanicsM2M5

Fig 1.This picture was taken moments after this patient was switched to APV. Adaptive Pressure Ventilation is a mode using an adaptive targeting scheme. Breaths are pressure-limited (the ventilator controls pressure, not flows during inspiration). However, we do not set the pressure above PEEP. We set a target volume and the ventilator titrates the pressure applied so the tidal volume delivered during the itime we set approximates the target volume chosen by us. This picture illustrates this titration process. After switching the patient to APV, the ventilator started giving a certain pressure above PEEP. Tidal volumes were lower than target, so the ventilator increased the amount of pressure it delivered on the next breath. Tidal volumes were still low, so the pressure delivered again increased. That kept happening until tidal volumes finally equaled our target. This happened when the pressure applied above PEEP (Delta Pinsp -> seen on the R lower corner of the screen) was 28cmH2O.

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