🗝️ Key Points

• ❌ Don’t chase perfect numbers: Adequate and safe is often better than “perfect but harmful.”
• 💨 Oxygenation levers: Start with FiO₂ and PEEP, but remember MAP is the true driver.
• 🫁 Ventilation levers: Adjust RR and TV, tailored to underlying physiology.
• 🚫 Watch your obstructive patients: Sometimes less RR is more.

📝 Introduction

When you take the airway, you take the wheel and you now control the patient’s oxygenation and ventilation. In this REBEL Crit episode, Dr. Lodeserto and Dr. Acker walk through the physiology, ventilator strategies, and clinical curveballs that separate calm control from chaos at the bedside.

🗝️ Key Points

• 💨 Start with Breath Types: Controlled, assisted, and supported breaths are the foundation of all modes.
• 🛌 Comfort Over “Best Mode”: No mode improves mortality — focus on patient synchrony and comfort.
• ✅ Know the Big 5 Modes: AC: All controlled or assisted (volume or pressure). PS: Fully spontaneous, great for SBTs. PRVC: Pressure-delivered, volume-targeted hybrid. SIMV: Mixed mode, less favored in adults. VS: Spontaneous mode with adaptive pressure.
• ⚠️ Watch for Pitfalls: PRVC may under-ventilate in agitation. SIMV often causes dyssynchrony.
• 🎯 Bottom Line: Master mode mechanics and match the vent to the patient — not the other way around.

📝 Introduction

Mechanical ventilation can feel overwhelming, especially when faced with a sea of ventilator modes and unfamiliar terminology. In Part 2 of the series, we go beyond breath types and delivery mechanics to explore the most used modes in the ICU. We will break down each one; explaining how it works, when to use it, and why the goal isn’t the “best mode” but the most comfortable one for the patient.

⏰ Highlights

• 00:00 Introduction to Rebel Cast
• 00:10 Highlighting the Incrementum Conference 2026
• 00:34 Meet the Founders of Incrementum
• 01:21 The Journey to Incrementum
• 04:27 The Recognition of Emergency Medicine in Spain
• 06:04 What is Incrementum?
• 08:14 Bringing Together Top Emergency Medicine Experts
• 11:38 Exciting Sessions to Look Forward To
• 15:54 Conclusion and Invitation to Increment 2026

📝 Introduction

In this special episode of Rebel Cast, we spotlight the Incrementum Conference in Spain, a significant event in emergency medicine. Hosts welcome Dr. Francisco ‘Paco’ Campillo Palma and Dr. Carmen Maria Cano, founders of Incrementum, to discuss the recognition of emergency medicine as a specialty in Spain. They share their journey of creating the conference, emphasizing the importance of education, collaboration, and growth. The discussion also touches on this year’s conference highlights, including sessions on mental health and evidence-based medicine, and the exceptional lineup of speakers. Listeners are encouraged to attend the conference in April 2026 for an enriching experience.

📌 Bottom Line

• Join us in Spain this April for the Increment Conference!
• 👉 Register now at incrementum-conference.com