Initiation of mechanical insufflation

As with volume-controlled ventilation, pressure-controlled ventilation may be initiated automatically or synchronized with spontaneous inspiration. However, after the triggering event, the microprocessor is programmed to sustain the selected pressure at the site of measurement. In contrast with the trigger event, the site of pressure measurement during pressure-controlled insufflation may affect ventilator performance.

Manufacturers typically cite the 'fast' response of their inspiratory valve(s) as performance evidence to promote their mechanical ventilator. However, the response of an isolated valve is of the order of several milliseconds, whereas the response of the ventilator is in the order of several hundred milliseconds. Therefore factors other than the response time of an isolated inspiratory valve determine the general performance of the mechanical ventilator. Other factors contributing to delay in achieving desired pressurization of the patient circuit and inability to sustain a selected pressure include design and function of the inspiratory valve(s) and expiratory valve, the triggering mechanism, and the electronic logic (algorithm design, sensor signal transmission and processing, and speed of computation).

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