Volume Support (Volume Guaranteed Pressure Support)

This tutorial is about Volume Guaranteed Pressure Support - known generally as Volume Support (VS). This, I believe, is an underused mode of ventilation in most ICUs - who prefer to use pressure support. Essentially you specify the desired tidal volume and the ventilator alters to pressure support from breath to breath to deliver something akin to that volume. There is little precision, but - as pressure support is biologically variable anyway - the presence of a volume averaged set of tidal breaths is reassuring, particularly if the bedside practitioner is distracted or inexperienced. In the tutorial I explain how to set up volume support, what it looks like on three different ventilators - Puritan Bennett, Drager Evita and Servo-i and the strengths and limitations. @ccmtutorials www.ccmtutorials.org Contents: 00:08 Introduction 00:40 Review of Previous Tutorial 01:12 Preview 01:25 Clinical Scenario - Loretta 01:40 Assisted Spontaneous Breathing 02:05 Limitations of Pressure Support 02:30 Volume Support - what it is 03:38 How to Set Up Volume Support - various ventilators 05:44 Why it is essential to set Pmax 05:54 The Pressure Limit 07:10 How it Works - Servo-I 08:05 Cycling to Exhalation 08:45 Volume Guaranteed Pressure Support Waveforms 11:30 Advantages to Using VG-PS (Volume Support) 13:30 Drawbacks to Using VG-PS (VS) 15:00 PS vs VS and Worsening Lung Compliance 18:15 VS vs PS vs TC 19:00 Review of Tutorial and Preview of Next Tutorial (BILEVEL)