Intermittent Mandatory Ventilation IMV

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Intermittent Mandatory Ventilation
IMV

• RC 270

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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

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Ex. 1 IMV of 8, Vt900 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.

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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 patients spontaneous Ve
• Often done with neuro patients
• To get a lower mean intrathoracic pressure than
  A/C

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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.
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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 patients OBSERVED Ve when he was
  on A/C
• Titrate IMV Ve based on ABGs and patients
  spontaneous Ve