Pressure Control Ventilation Monitoring
Key Points
- In pressure-control ventilation, inspiratory pressure is fixed and delivered tidal volume varies with lung mechanics.
- Continuous trend monitoring of delivered volumes is essential to confirm effective and safe ventilation.
- Changes in compliance or resistance can rapidly alter volume delivery without a setting change.
Equipment
- Ventilator running AC pressure-control mode
- Bedside display/trending for tidal volume, inspiratory flow, and I:E ratio
- Current order set including RR, pressure control level, inspiratory time, PEEP, and FiO2
- Structured handoff documentation for trend comparison over time
Procedure Steps
- Confirm the patient is on pressure-control mode and verify ordered set parameters.
- Verify directly set parameters: respiratory rate, pressure control, inspiratory time, PEEP, and FiO2.
- Identify key observed variables that are not directly set: tidal volume, inspiratory flow, and I:E.
- Establish baseline observed values immediately after settings are confirmed.
- Trend delivered tidal volume over time to detect improvement or deterioration in lung mechanics.
- Correlate abrupt tidal-volume changes with possible compliance/resistance changes and reassess patient status.
- Notify respiratory therapy/provider promptly when delivered volume is no longer in a safe/effective range.
- Reassess after each setting change and document mode, set values, observed trends, and response.
- Continue repeated trend checks at routine intervals and during clinical deterioration.
Common Errors
- Assuming fixed pressure guarantees stable ventilation → missed low- or high-volume risk.
- Failing to trend tidal volume over time → delayed recognition of worsening compliance/resistance.
- Ignoring observed I:E and flow changes → incomplete assessment of ventilator-patient interaction.
- Delayed escalation after unsafe volume trend → preventable hypoventilation or lung injury.
Related
- invasive-mechanical-ventilation-modes - Concept-level comparison of ACVC and ACPC behavior.
- assist-control-ventilator-initial-settings-check - Initial setup verification precedes ongoing mode-specific monitoring.