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Types of Respiratory Ventilators
- Intensive-care Ventilators ( ICU )
These ventilators are larger and usually run on AC power (though virtually all contain a battery to facilitate intra-facility transport and as a back-up in the event of a power failure). This style of ventilator often provides greater control of a wide variety of ventilation parameters (such as inspiratory rise time). Many ICU ventilators also incorporate graphics to provide visual feedback of each breath.
- Neonatal Ventilators
Designed with the preterm neonate in mind, these are a specialized subset of ICU ventilators that are designed to deliver the smaller, more precise volumes and pressures required to ventilate these patients.
- Transport Ventilators
These ventilators are small and more rugged, and can be powered pneumatically or via AC or DC power sources.
Popular Brands of Ventilators
- Maquet - ( Servo I )
- Covinden - ( Puritan Bennett, Newport )
- Carefusion - ( Pulmonetic, Viasys )
- Philips - ( Respironics )
- Drager - ( Babylog, Evita, Savina )
- GE - ( iVent, Engstrom )
Methods of Ventilation
Because of advancements in technology more and more types of traditionally invasive ventilators are now in addition offering noninvasive ventilation as standard or an optional upgrade.
- Invasive Ventilation
Patients on long-term ventilation may require ventilation through an endotracheal tube inserted through the mouth or nose, or through a tracheostomy tube inserted into an incision in the in the neck.
- Noninvasive Ventilation (NIV)
These devices provide breathing support through an external interface, such as a mask or nasal prongs. The use of noninvasive ventilation increased significantly since 2000 and is becoming an important tool for managing of both acute and chronic respiratory failure. This would be true in home settings or in critical care units and ICUs. Noninvasive ventilation has can not always be used as a replacement for invasive ventilation but its flexibility allows it to be a valuable complement in patient management.
- Positive Airway Pressure Ventilation (PAP)
These ventilators are specifically designed for non-invasive ventilation. This includes ventilators for use at home for treatment of chronic conditions such as sleep apnea or COPD.
- Noninvasive Negative-Pressure Ventilation ( Older Technology )
Negative-pressure ventilators provide ventilatory support using a device that encases the thoracic cage starting from the neck, and devices range from a whole-body tank to a cuirass shell. The general principal is the same with a vacuum device. These ventilators have been largely supplanted by the more widespread positive-pressure noninvasive ventilators.
Ventilator Modes of Operation
Respiratory ventilators are often best categorized by how they deliver gas flow and how they trigger inspiration and expiration. Answering some basic questions will help simplify the concepts:
- Is the ventilator mode pressure or volume?
- Is inspiration assisted, assisted/controlled, or controlled?
- Is switching from inspiration to expiration flow or time cycled?
Ventilation Mode Terminology
Terminology related to respiratory ventilators can be obscure, redundant and confusing at times. Be aware that many manufacturers create proprietary features that are very similiar to competitors and name the feature differently. Below are some common terms you will see and what they refer to.
- VC - Volume Control
- CMV - Volume Control Continuous Mandatory
CMV - Control Mode
ACMV or ACV - Assist Control Mode
VCV - Volume Control
VCV - Volume Cycled
VTV - Volume Targeted
CV - Controlled
- IMV - Intermittent Mandatory
SIMV - Synchronized intermittent mandatory
VS - Volume Support
- PC - Pressure Control
PCV - Pressure Controlled
IRV - Inverse Ratio
ASV - Adaptive Support
PCIRV - Pressure Controlled Inverse Ratio
APRV - Airway Pressure Release
- Dual Modes
PRVC - Pressure Regulated Volume Control
AVAPS - Average volume Assured Pressure Support
IVAPS - Intellegent Volume Assured Pressure Support
- Interactive & Spontaneous Breathing
CSV - Continuous Spontaneous
ATC - Automatic Tube Compensation
PEEP - Positive end-expiratory pressure
PSV - Pressure Support
ASV - Adaptive Support
MMV - Mandatory Minute
NAVA - Neurally Adjusted Ventilatory Assist
PAV - Proportional Assist
- Positive Airway Pressure Modes
NIPPV - Noninvasive Positive Pressure
CPAP - Continuous Positive Airway Pressure
BPAP - Bilevel Positive Airway Pressure
IPAP - Inspiratory Positive Airway Pressure
EPAP - Expiratory Positive Airway Pressure