Mandatory minute ventilation

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Mandatory minute ventilation (MMV) (also called minimum minute ventilation) is a mode of mechanical ventilation which requires the operator to determine what the appropriate minute ventilation for the patient should be and the ventilator then monitors the patient's ability to generate this volume. If the calculation suggests the volume target will not be met, supplemental breaths are delivered at the targeted volume to achieve the desired minute ventilation.

Application

Mandatory minute ventilation is a volume control mode of ventilation and a derivative of intermittent mandatory ventilation.^[1] Mandatory minute ventilation allows spontaneous breathing with automatic adjustments of mandatory ventilation to meet the patient’s preset minimum minute volume requirement. If the patient maintains the minute volume settings for VT x f, no mandatory breaths are delivered. If the patient's minute volume is insufficient, mandatory delivery of the preset tidal volume will occur until the minute volume is achieved. The method for monitoring whether or not the patient is meeting the required minute ventilation (V_E) is different per ventilator brand and model, but generally there is a window of time being monitored and a smaller window being checked against that larger window.

Ventilation of neonatal patients

MMV is an optimal mode for weaning in neonatal and pediatric populations and has been shown to reduce long term complications related to mechanical ventilation.^[2]

References

^ Hewlett AM, Platt AS, Terry VG (February 1977). "Mandatory minute volume. A new concept in weaning from mechanical ventilation". Anaesthesia. 32 (2): 163–9. doi:10.1111/j.1365-2044.1977.tb11588.x. PMID 322535.
^ Guthrie SO, Lynn C, Lafleur BJ, Donn SM, Walsh WF (October 2005). "A crossover analysis of mandatory minute ventilation compared to synchronized intermittent mandatory ventilation in neonates". J Perinatol. 25 (10): 643–6. doi:10.1038/sj.jp.7211371. PMID 16079905.

v t e Mechanical ventilation
Fundamentals	Modes of mechanical ventilation Mechanical ventilation in emergencies Nomenclature of mechanical ventilation
Modes	IMV/SIMV CMV ACV CSV PAP BPAP/NIV CPAP APRV MMV PAV ASV HFV List of modes by category
Related illness	ARDS Atelectotrauma Biotrauma Pulmonary barotrauma Pulmonary volutrauma Rheotrauma Ventilator-associated pneumonia Oxygen toxicity Ventilator-associated lung injury
Pressure	P_EEP FiO₂ Δ_P P_IP P_S P_AW P_plat
Volumes	V_T V_E V_f
Other	C_dyn C_static P_AO₂ V_D/V_T OI A-a gradient Mechanical power

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