Alarm setting in mechanical ventilation: I’ll be there for you

Abstract

Alarm settings in mechanical ventilation are a constant concern in intensive care nursing, witch answer cannot be universal but indivudal and depending on the context. Broadly three clinical phases can be individualized for patients in mechanical ventilation.

In first one, acute phase, goals are oxynegation and lung rotection, involving a strictly controlled ventilation in Volume Assisted Contrelled (VAC) mode with tighten alarms, strictement, partucularly on Respiratory Rate (RR) and Peak Pressure.

In second one, transition phase to withdrawal, patient have to be awaked and supported from VAC to decreasing Pressure Support (PS), involving make patient respiratory works whilst avoiding respiratory exhausting. A RR alarm in high range and a Volume per Minnite (V/M) alarm quite permissive appear adapted.

In last phase, withdrawal expectation, patient does not (or does no longer) suffering respiratory illness. In light PS, alarms must be permissive and respect patient rhythm : RR and V/M low range in rest (if ever very low during sleep) and high range during effort.