hi all,
can we consider PSV with Guaranteed tital volume mode as a SIMV mode. why Because SAIME (france ,HELIA model)they don't have SIMV mode. instead Using PSV MODE we can wean the PTS. Is it possible..please let me know..
thanks..
regards,
mura

I assume you are talking about the Drager Babylog Ventilator (or Neomode or Neoflow---whatever Neo is on the E4)....

This mode is a bit of a hybrid of various modes---PSV, VC, A/C, SIMV

I prefer to characterize it as flow and time termination "friendly" Assist Control,

In PSV with volume guarantee..

Every breath has a volume target

If the patient doesn't initiate a breath within the set time frame then the ventilator initiates a breath. If the set rate is 40 and the patient initiates a breath in between each controlled one then each breath will still be targeting a PSV level to attain the dialed in tidal volume.

Every breath, whether patient initiated or not, still is flow terminated (15% of the peak). (not like S/T mode on the Vision). So while the breath termination puts it in the PS camp, the fact that it has a backup rate and that every breath is sought to be elastically unloaded (VT) to the same degree, puts it squarely in the assist control camp. If the PSV-VG breaths alternated with "pure" PS or some other influence one might be excused for using the SIMV label. But that is hardly the case with PSV-VG.

I suppose in a most "schizo" of scenario's--where the patient was sucking in hard one breath and then going totally limp for the next--the tidal volume might not ever be what is set.

You could reduce the PSV, but only by reducing the set tidal volume....again just like Assist Control.

For those whom still abhor assist control....is PSV with VG a wolf in sheep's clothing?