FLIGHT MEDICAL
Pressure Regulated Volume Control
Mode
PRVC
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Pressure Regulated Volume Control
(PRVC)
• Considered Dual Mode of Ventilation
• Combines the advantages of both Volume
Controlled & Pressure Controlled Ventilation
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Pressure Regulated Volume Control
• In PRVC ventilator will attempt to deliver
desired set tidal volume (Vt) using the
lowest possible pressure
• PRVC available in ACMV & SIMV
• Use clinically as you would standard volume control
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PRVC
• Similar modes on other ventilator brands:
– Autoflow
– Adaptive Support
– Volume Ventilation Plus
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Drager Evita
Hamilton Galileo
Puritan Bennett 840
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PRVC
• How does PRVC work
When switching to PRVC mode the ventilator
first delivers a set of volume ‘test’ breaths to
determine lung compliance and the necessary
pressure required to deliver the targeted
volume.
Note: this is also done anytime ventilation is interrupted. i.e.
suctioning, opening the circuit, etc.
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PRVC
• Pressures are then adjusted breath by breath,
regulating the amount of pressure needed to
achieve set Vt
• Maximum change in pressure per breath +/- 3
cm H2o. Therefore, achieving target Vt is
accomplished over a number of breaths
• +/- 10% of set Vt
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PRVC FLOW CHART
Test
Breath
Measured Vt
More
than
Set Vt
Compare
to Set Vt
Less
than
set Vt
Equal
Decrease
Inspiratory
Pressure
Give same
Insp
pressure
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Increase
Inspiratory
Pressure
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PRVC Clinical Advantages and
Disadvantages
• Advantages of PRVC
– ‘Guarantees’ delivery of Vt
– Minimizes risk of barotrauma due to increased
peak pressures
– Decelerating flow pattern may provide better
distribution of ventilation & oxygenation
– Can better meet inspiratory flow demands
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PRVC Clinical Advantages and
Disadvantages
• Disadvantages of PRVC
-Ventilator may potentially increase
pressures to higher than desired levels in an
attempt to deliver set Vt.
Set appropriate High P alarm Typical setting 35-40 cm H2o
High P alarm is both an alarm and a limit
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PRVC Clinical Advantages and
Disadvantages
• Disadvantages of PRVC modality
– It takes a number of ventilator delivered breathes
to achieve set Vt; therefore if the patient coughs a
lot / fighting the ventilator / a lot of suctioning
they will likely not receive set Vt during these
events
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How to set up PRVC on the Flight 60
• In PRVC the following breath controls are
required:
– Target VCV (This is the target tidal volume)
– Rate: Breath Rate
– Ti Inspiratory Time
The maximum airway pressure never exceeds the
set high pressure (High P) alarm limit
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How to set up PRVC on the Flight 60
• PRVC is available in ACMV & SIMV modes
• To set the PRVC sub-mode of ventilation
1. Tap the sub-modes
control button
2. Select PRVC
& press Enter
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Parameters to set in PRVC
• Trigger- pressure or flow
• Peep
• PSV above peep – minimum applied pressure to
support a breath
• Ti – Inspiratory time
• VCV – Target tidal volume
• Modes: ACMV/SIMV Sub mode: PRVC
• Fio2 % / 100% o2
• Alarm button
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How to set up PRVC on the Flight 60
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Setting Alarms in PRVC
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•
•
•
•
•
•
High rate / Low rate
Low Vte / Low Vti
Apnea Interval
Low / High MV
Low / High Fio2
P High – *Pressure Limit, alarm
P Low - * Pressure Limit, alarm
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Setting Alarms in PRVC
Alarm Screen
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Thank you
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