Adjusting the %MinVol in ASV mode

文章

作者: Aleh Satsishur, Simon Franz

日期: 08.09.2020

Last change: 07.09.2020

(First published 24.08.17) Removal of recommendation to adjust patient height to compensate for additional dead space.

What are the recommendations for the initial %MinVol settings in Adaptive Support Ventilation® (ASV®)?

Initial setting

A logical starting point is setting a %MinVol value that will result in the same minute volume as a previous mode, if applicable.

For example, the %MinVol could be set as follows:

Normal patient: 100%
Chronic hypercapnia patient: 100%
ARDS patient: 120%

Add 20% if the body temperature exceeds 38.5°C (101.3°F) and 5% per 500 m (1640 ft) above sea level.

In the table shown here below the clinical workflow, you can see recommendations regarding %MinVol changes for various clinical conditions. For more information on adjustment of %MinVol in ASV mode, see your Hamilton Medical ventilator’s Operator’s Manual.

Flowchart showing ASV settings and adjustments — ASV clinical workflow

Condition	%MinVol change	Remarks
Normal arterial bloodgas	None	--
High PaCO2	Increase %MinVol	Pay attention to inspiratory pressures
Low PaCO2	Decrease %MinVol	Pay attention to mean airway pressure and oxygenation status
High respiratory drive	Consider increasing %MinVol	Consider sedation, analgesia or other treatments
Low Oxygen saturation	None	Consider increasing PEEP and/or Oxygen