Modes of Respiratory Support

It is of foundational importance that the critical care transport clinician understands the modes of support available to manage the patient in respiratory failure. Looking first at noninvasive modes, this chapter reviews the breadth and specifics of various oxygenation supplementation types in order of increasing flow and fractional oxygen content, from nasal cannula and reservoir devices to high-flow nasal cannula (HFNC). Turning then to noninvasive ventilatory support, we review continuous positive airway pressure (CPAP), bilevel positive airway pressure (BIPAP), and the bag-valve-mask with positive end-expiratory pressure (PEEP) valve. Finally, we conclude by delving into invasive respiratory support, reviewing six of the most common modes of positive pressure ventilation typically delivered via an advanced airway. These include pressure support (PS), assist control (AC), synchronized intermittent mandatory ventilation (SIMV), adaptive support ventilation (ASV), pressure-regulated volume control (PRVC), and airway pressure release ventilation (APRV).