RT Book, Section A1 Sassoon, Catherine S. A2 Tobin, Martin J. SR Print(0) ID 57062605 T1 Chapter 7. Intermittent Mandatory Ventilation T2 Principles and Practice of Mechanical Ventilation, 3e YR 2013 FD 2013 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-173626-8 LK accessmedicine.mhmedical.com/content.aspx?aid=57062605 RD 2024/03/29 AB Intermittent mandatory ventilation (IMV) allows the patient to breathe spontaneously between machine-cycled or mandatory breaths. This concept originated in 1955 with an unnamed ventilator designed by Engstrom.1,2 In the early 1970s, Kirby et al3,4 introduced IMV as a means of ventilator support of infants with respiratory distress syndrome. In 1973, Downs et al5 were the first to propose IMV as a method to facilitate discontinuation from mechanical ventilation in adults. Those investigators6,7 also pioneered IMV use as a primary means of ventilator support during acute respiratory failure. Subsequently, breath-delivery design has been modified. Mandatory breaths initially delivered regardless of respiratory timing are synchronized with the patient’s inspiratory effort.8,9 This mode of ventilation has been termed intermittent demand ventilation, 8 intermittent assisted ventilation,9 and synchronous intermittent mandatory ventilation (SIMV). SIMV is an established partial mechanical ventilation mode in critically ill patients, both adult10 and neonate, worldwide.11 Currently, however, SIMV application in adults has declined except in North America12 and Australia–New Zealand,13 whereas in neonates, SIMV application remains prevalent.14 This chapter uses the terms IMV and SIMV interchangeably unless specifically indicated for clarification.