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Describe Intemittent Mandatory Ventilation (IMV)
Mandatory breaths are delivered at set tidal volumes and rates, and the patient can breathe on his own in between through a unidirectional valve in between (Fig 5). Unlike in ACV, a machine breath is not initated with each patient effort - thus the risk of overventilation is reduced. A refinement of this mode is Synchronous Intermittent Mandatory Ventilation (SIMV) - here the machine breaths are synchronized to patient efforts if it falls within a "window period" of the cycle.
Figure: The IMV Circuit
if i start in the superior mesenteric vain where do i have to go through to get to the left anterior circumflex humeral artery. by the way of the hepatic portal vein and the heart
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