Abstract
There has been a dramatic increase in the number and complexity of new ventilation modes over the last 30 years. The impetus for this has been the desire to improve the safety, efficiency, and synchrony of ventilator-patient interaction. Unfortunately, the proliferation of names for ventilation modes has made understanding mode capabilities problematic. New modes are generally based on increasingly sophisticated closed-loop control systems or targeting schemes. We describe the 6 basic targeting schemes used in commercially available ventilators today: set-point, dual, servo, adaptive, optimal, and intelligent. These control systems are designed to serve the 3 primary goals of mechanical ventilation: safety, comfort, and liberation. The basic operations of these schemes may be understood by clinicians without any engineering background, and they provide the basis for understanding the wide variety of ventilation modes and their relative advantages for improving patient-ventilator synchrony. Conversely, their descriptions may provide engineers with a means to better communicate to end users.
Footnotes
- Correspondence: Robert L Chatburn MHHS RRT-NPS FAARC, Respiratory Therapy, M-56, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland OH 44195. E-mail: chatbur{at}ccf.org.
Mr Chatburn has disclosed relationships with IngMar, Hamilton, Covidien, Dräger, CareFusion, Newport, IngMar, Radiometer America, Breathe
Technologies, and the Alpha-1 Antitrypsin Foundation. Dr Mireles-Cabodevila has disclosed no conflicts of interest.
Mr Chatburn presented a version of this paper at the 46th Respiratory Care Journal Conference, “Patient-Ventilator Interaction,” held March 19-21, 2010, in Cancún, Quintana Roo, Mexico.
↵* Magdy Younes MD FRCP(C) PhD, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
- Copyright © 2011 by Daedalus Enterprises Inc.