The role of ventilator graphics when setting dual-control modes.

Dual-control ventilation modes were introduced with the goal of combining the advantages of volume-control ventilation (constant minute ventilation) and pressure-control ventilation (rapid, variable flow). Dual-control ventilation modes have gained popularity despite little evidence to support routine use. The individual operation and response of the dual-control modes must be understood by the clinician to allow safe and effective use. Graphic displays of pressure, volume, and flow can aid the clinician in detecting inappropriate use of dual-control modes and adjusting settings accordingly. Inspecting the waveforms will lead clinicians to the realization that dual-control does not guarantee a set tidal volume and that variability in delivered tidal volume is greater with dual-control than with pressure control. These realizations have important implications for low-tidal volume strategies.