Neonatal Nurse Practitioner Practice Exam

How does Synchronized Intermittent Mandatory Ventilation (SIMV) function?

1. It uses a fixed respiratory rate with no patient involvement

2. Breaths are scheduled based on the infant's respiratory efforts

3. It provides continuous pressure regardless of the infant's efforts

4. All breaths are mandated without support from the infant

The correct answer is: Breaths are scheduled based on the infant's respiratory efforts

Synchronized Intermittent Mandatory Ventilation (SIMV) is a mode of mechanical ventilation that combines mandatory ventilation with spontaneous breathing. The primary function of SIMV is to provide a certain number of mandatory breaths at preset intervals, while simultaneously allowing the infant to initiate additional breaths on their own. This approach is particularly beneficial in supporting infants who may have variable respiratory effort, as it allows for synchronization. When the infant makes an inspiratory effort, the ventilator detects this and assists with the breath, which ensures that the infant receives the necessary support without completely taking over their breathing. This allows for a more adaptive and responsive ventilation strategy, offering both support for weaker respirations and promoting the infant’s own respiratory effort. The other options describe modes of ventilation that do not incorporate patient effort or synchronization: - A refers to a completely controlled mode with no patient input, which is not characteristic of SIMV. - C describes continuous positive airway pressure (CPAP) or a similar mode, which does not allow for periods of spontaneous effort by the patient. - D suggests a completely controlled ventilation mode without any contribution from the infant, which also does not align with how SIMV operates. Thus, the emphasis on scheduling breaths based on the infant's respiratory efforts