Difference between revisions of "PCD RTM Vent Modes"
ToddCooper (talk | contribs) m (Initial Version) |
ToddCooper (talk | contribs) m (→Reference Documents: Added link to updated Furniss document) |
||
(11 intermediate revisions by 3 users not shown) | |||
Line 1: | Line 1: | ||
− | + | {{TOCright}} | |
− | |||
− | + | ==Ventilator Operational Configuration Semantic Model== | |
+ | A key item in the Vent TG's discussion is to identify the core semantic components that make up a ventilator's operational modality. This in turn can be used to organize a device's settings, waveform annotations, etc. It is understood that the actual labels associated to a given mode will vary from vendor's device to device, and should eventually be harmonized with related activities such as the work being done within [http://www.iso.org/iso/standards_development/technical_committees/list_of_iso_technical_committees/iso_technical_committee.htm?commid=52024 ISO TC121/SC 4 (Joint with IEC/SC62D) Critical Care Ventilators]. Component semantics should be flexible enough to support all of these usages, though. | ||
− | + | Note: This is also intended to result in an update to the existing ventilator operational modality terminology standard contained in ''ISO/IEEE 11073-10101 Health informatics - Point-of-care medical device communication - Nomenclature document'', as well as a mapping to any "glossary" developed within ISO TC121/SC4. | |
− | |||
+ | == Operational Configuration Data Set == | ||
+ | Given the complexity and versatility of how a ventilator is configurated, mapping all the operational settings concepts into a single term or semantic model is a fairly intractable proposition. To address this complexity, a set of parameters has been proposed to convey how a device's operation has been configured. | ||
{|border="2" | {|border="2" | ||
− | |+ <big>'''Ventilatator Operational | + | |+ <big>'''Ventilatator Operational Configuration Data Set</big> |
|- | |- | ||
! width="15%" align="center" |Atrribute | ! width="15%" align="center" |Atrribute | ||
! width="45%" align="left" |Description | ! width="45%" align="left" |Description | ||
− | ! align="left" | | + | ! align="left" |Enumerations |
|- | |- | ||
| align="center" | '''Patient Interface''' | | align="center" | '''Patient Interface''' | ||
− | | | + | | Indicates the general mechanical connection between the patient and the ventilator. |
− | : | + | | |
+ | :'''IV'''- Invasive, e.g. endotracheal tube | ||
− | : | + | :'''NIV'''- Non-Invasive |
− | |||
|- | |- | ||
| align="center" | '''Delivery Method''' | | align="center" | '''Delivery Method''' | ||
− | | | + | | Overall approach for achieving gas delivery. |
− | : | + | |
+ | Note: This mode setting may end up selecting a different set of "operational mode" enumerations. Those listed below are specifically related to Positive Pressure delivery method, which is used for conventional mechanical ventilation. | ||
+ | | | ||
+ | :'''PP'''- Positive Pressure | ||
+ | |||
+ | :'''NP'''- Negative Pressure | ||
+ | |||
+ | :'''HF'''- High Frequency | ||
+ | |||
+ | |- | ||
+ | | align="center" | '''Operational Mode''' | ||
+ | | General intra- and inter- breath sequencing. | ||
+ | | | ||
+ | :See [[#Operational_Mode_Attributes_Positive_Pressure | Operatinal Mode below]] | ||
+ | |- | ||
+ | | align="center" | '''Backup Mode''' | ||
+ | | Mode that is actived when an apnea condition is detected. | ||
+ | | | ||
+ | :See [[#Operational_Mode_Attributes_Positive_Pressure | Operatinal Mode below]] | ||
+ | |} | ||
+ | |||
+ | |||
+ | |||
+ | == Operational Mode Attributes (Positive Pressure) == | ||
+ | For conventional "positive pressure" mechanical ventilation, the following table captures the key attributes that may be used to describe its operational mode. | ||
+ | |||
+ | Note: These attributes are listed in the preferred sequential precedence. | ||
+ | |||
− | | | + | {|border="2" |
+ | |+ <big>'''Ventilatator Operational Mode Attributes (Positive Pressure)''' </big> | ||
+ | |- | ||
+ | ! width="15%" align="center" |Atrribute | ||
+ | ! width="45%" align="left" |Description | ||
+ | ! align="left" |Discussion | ||
|- | |- | ||
| align="center" | '''Breathing Pattern''' | | align="center" | '''Breathing Pattern''' | ||
| <general semantic attribute description> | | <general semantic attribute description> | ||
− | : | + | :'''CMV''' - Continuous Mandatory Ventilation: |
+ | |||
+ | :'''IMV''' - Intermittent Mandatory Ventilation: | ||
+ | |||
+ | :'''CSV''' - Continuous Spontaneous Ventilation: | ||
| ... | | ... | ||
Line 39: | Line 76: | ||
| align="center" | '''Breath Shape''' | | align="center" | '''Breath Shape''' | ||
| <general semantic attribute description> | | <general semantic attribute description> | ||
− | : | + | :'''P''' - Pressure): |
+ | |||
+ | :'''F''' - Flow): | ||
+ | |||
+ | :'''PF''' - Pressure transitioning to Flow: | ||
+ | |||
+ | :'''FP''' - Flow transitioning to Pressure: | ||
+ | |||
+ | :'''V''' - Volume...integral of flow: | ||
+ | |||
+ | :'''T''' - Time): | ||
− | | | + | | |
+ | * Is ''BreathShape::Time'' redundant since time is ALWAYS a component? | ||
+ | * Are all combinations of trigger & cycle methods accounted for in these enumerations? | ||
|- | |- | ||
| align="center" | '''Adaptive Targets''' | | align="center" | '''Adaptive Targets''' | ||
| <general semantic attribute description> | | <general semantic attribute description> | ||
− | : | + | :'''NOS''' - Not Otherwise Specified: |
+ | |||
+ | :'''MMV''' - Mandatory Minute Volume: | ||
− | | . | + | :'''V''' - Volume: |
+ | |||
+ | :'''FQ''' - Frequency: | ||
+ | |||
+ | :'''EtO2''' - Control for O2 content: | ||
+ | |||
+ | :'''EtCO2''' - Control for CO2 content: | ||
+ | |||
+ | | | ||
+ | * Multiple targets may be active during any given operational mode. To account for this, should there be a primary Adaptive Target and then a separate list of the set of adaptive targets? | ||
|- | |- | ||
| align="center" | '''Assist Augmentation''' | | align="center" | '''Assist Augmentation''' | ||
| <general semantic attribute description> | | <general semantic attribute description> | ||
− | : | + | :'''TBD''' - ...: |
| Note: During the [[PCD_RTM_2008-05-15_WebEx|2008-05-15 WebEx]] it was decided to add another Attribute to this table - "Assist/Support Breath Augmentation" ''(final name TBD)''. | | Note: During the [[PCD_RTM_2008-05-15_WebEx|2008-05-15 WebEx]] it was decided to add another Attribute to this table - "Assist/Support Breath Augmentation" ''(final name TBD)''. | ||
Line 57: | Line 117: | ||
+ | == Reference Documents == | ||
+ | :[[PCD_RTM_Ventilator | RTM Vent Page Background Materials and Suggested References List]] | ||
+ | |||
+ | :[ftp://ftp.ihe.net/Patient_Care_Devices/Profiles/RTM/Vent/Background/IHE_PCD_RTM_Vent_Modes_Proposal_Table_r1.pdf Initial mode table proposal from Cambridge Meetings] | ||
+ | |||
+ | :[ftp://ftp.ihe.net/Patient_Care_Devices/Profiles/RTM/Vent/Background/Aphorisms_of_Mode_Classification-Chatburn_2008-06-23.doc Aphorisms of Mode Classification (Chatburn, 2008.06.23)] | ||
+ | |||
+ | :[ftp://ftp.ihe.net/Patient_Care_Devices/Profiles/RTM/Vent/Background/Analysis_of_Aphorisms_06-02-08_Chatburn.doc Analysis of Aphorisms (Chatburn, 2008-06-02 tcon)] | ||
+ | |||
+ | :[ftp://ftp.ihe.net/Patient_Care_Devices/Profiles/RTM/Vent/Background/Breath_mode_taxonomy_2_2008-06-22_Weismann.doc Breath Mode Taxonomy (Weismann, 2008.06.22)] | ||
+ | |||
+ | :[ftp://ftp.ihe.net/Patient_Care_Devices/Profiles/RTM/Vent/Background/Breath_mode_taxonomy_1_2008-06-22_Weismann.xls Breath Model Taxonomy- Excel (Weismann, 2008.06.22 tcon)] | ||
+ | |||
+ | :[ftp://ftp.ihe.net/Patient_Care_Devices/Profiles/RTM/Vent/20080529_tcon/Breath%20mode%20model%20.doc Furniss ventilator mode discussion document] | ||
+ | |||
+ | :[ftp://ftp.ihe.net/Patient_Care_Devices/Profiles/RTM/Vent/Background/Breath_mode_taxonemy_6-5-08_wwf_2.xls Furniss ventilator mode taxonomy matrix (updated 2008.07.07)] | ||
+ | |||
+ | :[ftp://ftp.ihe.net/Patient_Care_Devices/Profiles/RTM/Vent/Background/VentModeProposal.2008-07-08.table.doc Updated mode table proposal with Chatburn Mappings] | ||
+ | |||
+ | == Mode Issues / Action Items List == | ||
+ | The following table captures the current issues that need to be resolved regarding the above model: | ||
+ | |||
+ | |||
+ | :{|border="2" cellpadding="2" | ||
+ | |- | ||
+ | ! width="5%" align="center" |Item | ||
+ | ! width="8%" align="left" |Submitters | ||
+ | ! width="8%" align="left" |Attr | ||
+ | ! width="12%" align="left" |Topic | ||
+ | ! align="left" |Description | ||
+ | ! width="35%" align="left" |Discussion/Disposition | ||
+ | |- | ||
+ | | align="center" | 1 | ||
+ | | Berryhill | ||
+ | | Breath Shape | ||
+ | | PF or is it really PV? | ||
+ | | '''''Mark wanted to know if the BREATH SHAPE item should be classified as Pressure-Flow or Pressure-Volume. In his opinion, in a volume assured breath, you set the pressure, then maintain a flow until you reach the assured volume-Joel''''' | ||
+ | | . | ||
+ | |- | ||
+ | | align="center" | 2 | ||
+ | | tbd | ||
+ | | . | ||
+ | | . | ||
+ | | . | ||
+ | | . | ||
+ | |} | ||
+ | |||
+ | |||
+ | == Mode Mapping Sandboxes == | ||
+ | The table below may be used to try out mapping specific vent modes (real modes provided on real vents!) and to discuss issues with the model above - gaps, adjustments, etc. | ||
+ | |||
+ | ''NOTE: A sample table has been provided - copy that heading and table and then use it as a sandbox for your own mappings.'' | ||
+ | |||
+ | |||
+ | === Mode Sandbox Table: (Sample) === | ||
+ | |||
+ | :{|border="2" cellpadding="2" | ||
+ | |- | ||
+ | ! width="10%" align="center" |Mode Name | ||
+ | ! width="4%" align="center" |P/I | ||
+ | ! width="4%" align="center" |D/M | ||
+ | ! width="4%" align="center" |B/P | ||
+ | ! width="4%" align="center" |B/S | ||
+ | ! width="4%" align="center" |A/T | ||
+ | ! width="4%" align="center" |B/M | ||
+ | ! width="35%" align="left" |Description/Notes | ||
+ | |- | ||
+ | | High Freq | ||
+ | | IV | ||
+ | | HF | ||
+ | | n/a | ||
+ | | n/a | ||
+ | | n/a | ||
+ | | n/a | ||
+ | | ... | ||
+ | |- | ||
+ | | tbd | ||
+ | | tbd | ||
+ | | tbd | ||
+ | | . | ||
+ | | . | ||
+ | | . | ||
+ | | . | ||
+ | | ... | ||
+ | |} | ||
[[Category:PCD]] | [[Category:PCD]] |
Latest revision as of 09:38, 9 July 2008
Ventilator Operational Configuration Semantic Model
A key item in the Vent TG's discussion is to identify the core semantic components that make up a ventilator's operational modality. This in turn can be used to organize a device's settings, waveform annotations, etc. It is understood that the actual labels associated to a given mode will vary from vendor's device to device, and should eventually be harmonized with related activities such as the work being done within ISO TC121/SC 4 (Joint with IEC/SC62D) Critical Care Ventilators. Component semantics should be flexible enough to support all of these usages, though.
Note: This is also intended to result in an update to the existing ventilator operational modality terminology standard contained in ISO/IEEE 11073-10101 Health informatics - Point-of-care medical device communication - Nomenclature document, as well as a mapping to any "glossary" developed within ISO TC121/SC4.
Operational Configuration Data Set
Given the complexity and versatility of how a ventilator is configurated, mapping all the operational settings concepts into a single term or semantic model is a fairly intractable proposition. To address this complexity, a set of parameters has been proposed to convey how a device's operation has been configured.
Atrribute | Description | Enumerations |
---|---|---|
Patient Interface | Indicates the general mechanical connection between the patient and the ventilator. |
|
Delivery Method | Overall approach for achieving gas delivery.
Note: This mode setting may end up selecting a different set of "operational mode" enumerations. Those listed below are specifically related to Positive Pressure delivery method, which is used for conventional mechanical ventilation. |
|
Operational Mode | General intra- and inter- breath sequencing. | |
Backup Mode | Mode that is actived when an apnea condition is detected. |
Operational Mode Attributes (Positive Pressure)
For conventional "positive pressure" mechanical ventilation, the following table captures the key attributes that may be used to describe its operational mode.
Note: These attributes are listed in the preferred sequential precedence.
Atrribute | Description | Discussion |
---|---|---|
Breathing Pattern | <general semantic attribute description>
|
... |
Breath Shape | <general semantic attribute description>
|
|
Adaptive Targets | <general semantic attribute description>
|
|
Assist Augmentation | <general semantic attribute description>
|
Note: During the 2008-05-15 WebEx it was decided to add another Attribute to this table - "Assist/Support Breath Augmentation" (final name TBD). |
Reference Documents
Mode Issues / Action Items List
The following table captures the current issues that need to be resolved regarding the above model:
Item Submitters Attr Topic Description Discussion/Disposition 1 Berryhill Breath Shape PF or is it really PV? Mark wanted to know if the BREATH SHAPE item should be classified as Pressure-Flow or Pressure-Volume. In his opinion, in a volume assured breath, you set the pressure, then maintain a flow until you reach the assured volume-Joel . 2 tbd . . . .
Mode Mapping Sandboxes
The table below may be used to try out mapping specific vent modes (real modes provided on real vents!) and to discuss issues with the model above - gaps, adjustments, etc.
NOTE: A sample table has been provided - copy that heading and table and then use it as a sandbox for your own mappings.
Mode Sandbox Table: (Sample)
Mode Name P/I D/M B/P B/S A/T B/M Description/Notes High Freq IV HF n/a n/a n/a n/a ... tbd tbd tbd . . . . ...