Synchronized intermittent mandatory

SIMV-P — Synchronized IMV — Pressure

Synchronized intermittent mandatory ventilation, pressure-controlled. Mandatory breaths are synchronized to patient effort at a set rate; spontaneous breaths in between receive pressure support.

Waveforms

Spontaneous window — first 40% of EPAP duration.

Mandatory window — final 60% of EPAP duration.

No spontaneous effort → timed mandatory breaths.

SIMV-P — all event types (spontaneous / mandatory / none).

Physiological basis

SIMV delivers mandatory breaths at a set frequency while allowing spontaneous breathing during expiration, aligning the patient’s effort with the mandatory cycle.

In Ventisense the SIMV algorithm splits the EPAP duration into two windows. In the first 40% — the spontaneous window — a detected effort is supported with pressure support (PS) and the patient exhales by their own effort. In the final 60% — the mandatory window — a detected effort is treated as a mandatory breath and supported with IPAP (SIMV-P). If no effort occurs, the device delivers fully mandatory breaths at the set rate.

Adjustable parameters 11

IPAP

Inspiratory pressure for mandatory breaths.

PEEP

Positive end-expiratory pressure.

Frequency

Required number of breaths per minute.

Inspiratory Period

Inspiration time of mandatory breaths.

Pressure Support (PS)

Support pressure added to spontaneous breaths, on top of PEEP.

I-Slope

Rate of pressure rise.

Inspir. Trigger

Spontaneous effort detection threshold.

Exp. Trigger

Expiration-start criterion for spontaneous breaths (5%–100%).

Trigger Lock

Early re-triggering prevention.

Max./Min. Inspiration Time

Inspiration-time limits in spontaneous breathing.

Sigh

Atelectasis prevention: a periodic deep breath.

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