Is weaning off a ventilator from A/C better than weaning off from SIMV?

It has been suggested that weaning a patient off a ventilator is more successful if you mechanically ventilate them on A/C mode, titrate the mechanical rate to 4, and perform intermittent CPAP trials rather than mechanically ventilating them on SIMV mode, titrating the mechanical rate to 4, then proceeding to intermittent CPAP trials. Reasons for this include completely "resting" the patient on A/C in order to have a successful CPAP trial, and also maintaining a patient trigger by decreasing the mechanical rate before CPAP.





Followers of the SIMV method of weaning suggest that the patient must be allowed to slowly resume the task of breathing to allow for a successful CPAP trial by having their mechanical respiratory rate titrated from a high rate to a low rate before the initiation of CPAP. This allows for more spontaneous breathes to occur.





With the eventual extubation of the patient in mind, which method is more effective/efficient and why? For what kind of patients and ailments?

Is weaning off a ventilator from A/C better than weaning off from SIMV?
That is an opinion. SIMV is the way to go in my opinion. I like the SIMV mode because it allows the patient to do their own breathing if they so desire.
Reply:maybe

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