RT-02 · Initiation & Modification of Therapy

Mechanical Ventilation Fundamentals

Modes, initial settings, and the pressure readings that tell you whether the problem is the circuit, the airway, or the lung.

~28 min read7 concept sections·8 questions with rationale

What you'll be able to do

  • Select initial tidal volume, rate, FiO2, and PEEP for common presentations
  • Differentiate volume control, pressure control, and pressure support
  • Use peak and plateau pressures to localize the source of a high-pressure alarm
  • Recognize auto-PEEP and asynchrony from the waveform and the patient
Concept breakdown
01

Modes are just two questions

Every conventional mode answers who triggers the breath and what the ventilator guarantees once it starts.

  • Volume control guarantees tidal volume; pressure varies with compliance and resistance, so pressure is the alarm you watch.
  • Pressure control guarantees inspiratory pressure; volume varies, so delivered tidal volume is the number you watch.
  • Pressure support is patient-triggered and patient-cycled — no set rate, so it requires an intact respiratory drive.
  • SIMV delivers mandatory breaths synchronized to patient effort, with spontaneous breaths in between usually supported by pressure support.
Practice quiz

Check yourself before you read the rationale.

Question 1 of 1

A 70-kg (predicted body weight) patient with ARDS is on volume control: tidal volume 420 mL, rate 22, PEEP 12, FiO2 0.8. Plateau pressure is 33 cm H2O; pH 7.27, PaCO2 58. The best next step is:

Practice questions

Answer first, then read why the distractors fail.

Question 1

A 70-kg (predicted body weight) patient with ARDS is on volume control: tidal volume 420 mL, rate 22, PEEP 12, FiO2 0.8. Plateau pressure is 33 cm H2O; pH 7.27, PaCO2 58. The best next step is:

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