Classification of ventilator modes: update and proposal for implementation

Abstract

Ventilator manufacturers and the respiratory care academic community have not yet adopted a standardized system for classifying and describing ventilation modes. As a result, there is enough confusion that potential sales, education, and patient care are all put at risk. This proposal summarizes a ventilator-mode classification scheme and complete lexicon that has been extensively published over the last 15 years. Specifically, the classification system has 3 components: (1) a description of the breathing pattern and control variables within breaths, (2) a description of control type used within and between breaths, (3) a detailed description of adjunctive operational algorithms. This 3-level specification provides scalability of detail to make the mode description appropriate for the particular need. At the bedside we need only refer to a mode briefly using the first component. To distinguish between similar modes and brand names we would need to use at least the first and second components. For a complete and unique mode specification (as in an operator's manual) we would use all 3 components. The classification system proposed in this article uses the equation of motion for the respiratory system as the underlying theoretical framework. All terms relevant to describing ventilation modes are defined in an extensive glossary.