Modes of Mechanical Ventilation | mechanical ventilation modes

The Most Common Modes of Mechanical Ventilation

Mechanical ventilation is the process of using an external device (machine) to aid gaseous movement in and out of the lung. It serves as a type of life-saving device that facilitates breathing. Also, it’s widely used as an artificial breathing support in surgical cases, extremely ill situations, or when an individual is incapable of breathing on their own.  Various modes of mechanical ventilation play a great role in respiratory support, patient stabilization, and provision of pressure to prevent the alveoli from collapsing. Continue reading, as this article provides you with diverse mechanical ventilation modes and some of the most common modes of air circulation.

Modes of Mechanical Ventilation

Pressure Controlled Ventilation (PCV)

Pressure-controlled ventilation is a special kind of assisted respiration whereby a patient’s inspiratory pressure is predetermined. This mechanical ventilation mode provides an amount of aeration that depends on the compliance of the lungs and the resistance of the alveoli. It is an airflow system where the maximum airway force is constant and the total ventilation fluctuates. 

PCV is one of the most convincing pressure-limited ventilation (PLV) that is used regularly in the initial stages of newborn care. It is a technique recommended by different centers for preventing lobar emphysema. Although PCV reduces the risk of barotrauma, it could be challenging to provide a sufficient tidal volume (VT) when used in patients with ARDS. Also, an improper setting of this ventilator can lead to hypoxia and respiratory depression. 

Modes of Mechanical Ventilation

Volume Controlled Ventilation (VCV)

The modes of mechanical ventilation that involves a preset tidal volume to be provided in a specific amount of time is volume-controlled ventilation. It is usually more simple and comprehensible for most medical practitioners new to assisted air circulation. In this case, total ventilation is always set, the volume of breath supplied is constant, but the inspiratory pressure is unstable. 

Most of the time, VCV is commonly used in anesthesia, either in the assisted control (AC) mode or continuous mandatory ventilation (CMV). Due to the increase in peak pressure (PIP) with steady and accurate breathing volume, it usually causes uneven gaseous distribution and volutrauma. 

Pressure Support Ventilation (PSV)

A special mode of positive-pressure mechanical ventilation that requires patient initiation of each breath is known as pressure support ventilation. This kind of aided respiration can be administered either through the use of intubation (invasive) or with a mask (non-invasive) ventilatory pattern. It’s known as the most pleasant aided airflow with a useful system that delivers the benefits of the two types of ventilator patterns. 

PSV involves setting maximum driving pressure which usually indicates the ventilator flow rate. Sometimes, the patient’s pulmonary compliance, airway resistance, PIP, and breathing efforts frequently affect this flow rate. There is no minimum minute ventilation and the tidal volume provided is influenced by the flow and rate of breathing. Due to a volatile VT, it may also make the lung distend excessively. 

Pressure-Limited Time-Cycled Ventilation

Another type of PLV (similar to a pressure-controlled ventilator) that was previously used in neonates is the time-cycled PLV. This mechanical ventilation mode makes use of a predetermined peak pressure and a specified volume of gas within an extended period. While breathing in, this triggered ventilator provides a steady flow of air to the patient. 

Previous reports about the use of pressure-limited time-cycled ventilation have shown that lungs are usually susceptible to atelectrauma and barotrauma conditions. In addition, it has been observed that one of the primary factors influencing ventilator-associated lung injury (VALI) is Total ventilation (VT).

mechanical ventilation modes

Synchronized Intermittent Mandatory Ventilation (SIMV)

This is a unique mode of mechanical ventilation that provides a fixed tidal volume at a predefined frequency. In most cases, synchronized intermittent mandatory air circulation always permits patients to voluntarily breathe on their own. SIMV produces a mandatory breath that is delivered at the same moment the patient starts initiating their breath (spontaneous breath). In addition, positive end-expository pressure (PEEP) can also be administered using this synchronized IMV method. 

SIMV is mostly required by people with COPD, neuromuscular disorder, or ARDS and is used alongside pressure support ventilation. In some instances where SIMV is improperly used, there may be an inability to initiate spontaneous breath, fluctuations in intrathoracic force, or severe respiratory failure. This technique of ventilation is risky for hyperventilation, consumes much time, and can cause infection, barotrauma, or cardiac arrhythmias.

Modes of Mechanical Ventilation

High Flow Nasal Cannula (HFNC)

A high-flow nasal cannula is an oxygen therapy commonly called a heated, humidified, high-flow nasal cannula (HHFNC). It entails the delivery of a flexible blend of warmed, humid, and oxygen-rich air at a variable pace that surpasses spontaneous pulmonary flow. Whenever this aeration is used to provide oxygen, the flow is significantly greater than that with conventional nasal cannulas. 

In addition, HFNC enhances the functional residual capacity, and accurate distribution of oxygen. This mechanical ventilation mode often has an outcome of improved breathing efficiency due to continuous high oxygen flow that often washes out the anatomical dead space. 

Self Adjustable Ventilation (SAV)

Self Adjustable Ventilation is a special ventilator that makes use of detectors to constantly alter the airflow in response to changes in air properties. With the help of this technique, indoor comfort, improved air exchange systems, and environmental sustainability are guaranteed. This often allows great flexibility in ventilator parameters and also blends soothingly with a wide range of conditions.


The various modes of mechanical ventilation play a significant role in the therapeutic assistance for breathing. The use of any of these aeration systems depends on the patient’s tolerance, underlying issues, and medical purpose.

In some instances, PCVs’ are used because of their ability to lessen the risk of barotrauma and deliver the same volume with a lower peak airway force. However, many specialists utilize VCV for diseases with changing respiratory mechanisms due to its minute ventilation. 

Sometimes, most COPD patients are aided with SIMV mechanical ventilation mode as it has faster weaning airflow with a shorter ventilator reliance which improves patient comfort. On the other hand, to reduce patient work rate, a PSV coupled with CPAP or SIMV modes is used. 

The advancement in ventilation systems has been enormous, providing diverse modifications that improve patient tolerance and enhance their outcome. You can explore the different modes of ventilation and their impact, application, and improvement in the ICU and other healthcare sectors.











Mechanical Ventilation and ICU Ventilators: Learn All Details

What is Ventilation? 

ICU Ventilation is the process of movement of air from the atmosphere through the airways to the terminal respiratory gas exchange units by the effort of the respiratory muscles or mechanical ICU ventilators if the patient is being ventilated. 

What is Respiration? 

Oxygen is essential for life. It is required by each human cell for its survival. It is abundantly present in the atmosphere and maintains a remarkably constant concentration of 20.9% in ambient air. Oxygen is taken up by the lungs through the act of inspiration and transported to the cells via the blood. At the cellular level, oxygen is utilized for the production of energy. In this process, carbon dioxide is released and transported back via the blood to the lungs from where it is expired out into the atmosphere. The act of the exchange of oxygen and carbon dioxide is called respiration. 

What is the Difference Between ICU Ventilators and Respirator? 

A ventilator is a machine, a system using mechanical power and having several parts, each with a definite function and together performing a particular task. The task here is to provide all or part of the body’s work that is called breathing or ventilation. Respirator is an apparatus that people worn it over their mouth and nose or the entire face to prevent the inhalation of dangerous substances such as: dust, smoke, etc

Indications for Ventilation

⦁ Patients who require ventilatory support often develop a common pattern of physiological deterioration, including:
⦁ changes in respiratory rate
⦁ asynchronous respiratory pattern
⦁ changes in mental status and changes in level of consciousness
⦁ frequent oxygen desaturation despite increasing oxygen concentration
⦁ hypercapnia and respiratory acidosis
⦁ circulatory problems, including tachypnea, tachycardia, hypertension, or hypotension.(3)

Non-invasive Ventilation (NIV)

NIV refers to the provision of respiratory support without direct tracheal intubation. As such, it aims to avoid some of the complications inherent with invasive ventilation, such as the need for sedation with risks of hemodynamic instability and subsequent risk of delirium, nosocomial infection, etc.(2)
Recommendations for the use of non-invasive ventilation(4)
⦁ COPD exacerbations
⦁ Facilitation of weaning/extubation in patients with COPD
⦁ Cardiogenic pulmonary edema
⦁ Immunosuppressed patients
⦁ Do-not-intubate status
⦁ End-stage patients as palliative measure
⦁ Extubation failure (COPD or congestive heart failure) (prevention)
⦁ Community-acquired pneumonia in COPD
⦁ Postoperative respiratory failure (prevention and treatment)
⦁ Prevention of acute respiratory failure in asthma

Goals of Mechanical Ventilation

One of the most important treads of life support in the emergency department is Mechanical ventilation (MV). It provides time for recovery until the patient’s physiological balance is restored. This is why MV alone is not a unique and specific treatment for a particular disease; however, it has two general and main purposes: to support the injured lung and to protect the healthy lung.

Specific Goals of Mechanical Ventilation

⦁ Reversal of Apnea
⦁ Reversal of Respiratory Distress
⦁ Reversal of Severe Hypoxemia
⦁ Reversal of Severe Hypercapnia
⦁ Goals of Mechanical Ventilation in Postoperative
⦁ Respiratory Failure and Trauma
⦁ Goals of Mechanical Ventilation in Shock
One of the specific goals of MV is to promote the optimization of arterial blood gas levels and acid-base balance by providing oxygen and eliminating carbon dioxide (ventilation).(1) For patients with chronic diseases MV can reduce the work of breathing by taking effort from respiratory muscles and maintaining long-term respiratory support.
The ventilator is not a magical therapy that makes patients better but simply a supportive therapy used until more definitive therapies have time to work.


Patients with apnea, such as those who have suffered catastrophic central nervous system (CNS) damage, need the immediate institution of mechanical ventilation.(2)

Non-invasive ventilation

Indications (3)

⦁ Moderate to severe dyspnoea
⦁ Tachypnoea (>25–30 breaths/minute)
⦁ Signs of increased work of breathing (abdominal paradox; accessory muscle use)
⦁ Fatigue
⦁ Acute-on-chronic respiratory failure: pH <7.35; pCO2 >6
⦁ Hypoxaemia (use with caution): paO2/FiO2 <27 Kpa

Contraindications (3)

⦁ Facial burns/trauma/recent facial upper airway surgery
⦁ Vomiting
⦁ Upper gastrointestinal surgery
⦁ Copious respiratory secretions
⦁ Severe hypoxemia
⦁ Hemodynamically instability
⦁ Severe co-morbidities
⦁ Confusion/agitation
⦁ Low Glasgow coma score
⦁ Unable to protect the airway
⦁ Bowel obstruction
⦁ Respiratory arrest

NIV today consists almost exclusively of the delivery of positive pressure ventilation via an external interface. There are six broad types of interfaces available;

⦁ total face masks (enclose mouth, nose, eyes)
⦁ full-face masks (enclose mouth and nose)
⦁ nasal mask (covers nose but not mouth)
⦁ mouthpieces (placed between lips and held in place by lip seal)
⦁ nasal pillows or plugs (inserted into nostrils)
⦁ helmet (covers the whole head/all or part of the neck – no contact with face).(3)

Invasive Ventilation

Invasive mechanical ventilation requires access to the trachea, most commonly via an endotracheal tube, and represents the commonest reason for admission to the ICU.(5)ICU Ventilators.

Large multinational surveys confirm the common indications for invasive ventilation to be:
⦁ coma 16%
⦁ COPD 13%
⦁ ARDS 11%
⦁ heart failure 11%
⦁ pneumonia 11%
⦁ sepsis 11%
⦁ trauma 11%
⦁ postoperative complications 11%
⦁ neuromuscular disorders 5%.
⦁ NIV contraindications.(5)

Let’s Meet with Biyovent ICU Type Mechanical Ventilator

ICU Ventilators

Biyovent ICU Type Mechanical Ventilator

Biyovent ICU Ventilator makes a difference in the ventilation process with its unique specifications. Biyovent has been carefully thought out with every detail of the ventilators and developed with a holistic approach. Prepared for mass production in cooperation with Arçelik, Baykar, and Aselsan. ICU Ventilators

What are some specific features of Biyovent?

⦁ Invasive and Non-invasive Ventilation
⦁ Integrated Nebulizer
⦁ High Flow Oxygen Therapy
⦁ Suitable for Pediatric, Adult and Newborn (Optional) Patients
⦁ Smart Ventilation Modes

Learn more details about Biyovent ICU Ventilator

Get in contact with the Biosys Sales Team


1- Frank Lodeserto MD, “Simplifying Mechanical Ventilation – Part I: Types of Breaths”, REBEL EM blog, March 8, 2018. Available at:
2- Tobin M.J. 3rd edn. McGraw-Hill Education; 2012. Principles and practice of mechanical ventilation.
3- Popat B, Jones AT. Invasive and non-invasive mechanical ventilation. Medicine (Abingdon). 2012;40(6):298-304. doi:10.1016/j.mpmed.2012.03.010
4- Hess D.R. The evidence for noninvasive positive-pressure ventilation in the care of patients in acute respiratory failure: a systematic review of the literature. Respir Care. 2004;49:810–829.
5- Esteban A., Ferguson N.D., Meade M.O. Evolution of mechanical ventilation in response to clinical research. Am J Respir Crit Care Med. 2008;177:170–177