V. The explanation of the term
Another word is used for the same word to be used for another meaning by each manufacturer and for the term which is used for the resuscitator to mean the same thing and by the adequacy, it is confused. Moreover, a special engineering term and a technical term are used. However, the this manual used just as it is the term and the expression to be specified as much as possible of at the manual of the manufacturer. This is from the idea that there is not a difference summation sense when using the respiratory organs actually. Incidentally, this chapter is the explanation of the technical term which the manufacturer is using persistently and may be rather different from the explanation of the correct medical idiom.
A. The classification of the ventilation by the tense
The ventilation form of the resuscitator can be classified by the difference in the form of the operation with each step which is the of the (1) inspiratory-phase first way, the way of the corrugated adjustment during (2) intake, the way of the ending of (3) intake, pressure, a control of flow in the (4) expiration.
1. The beginning of the inspiratory-phase
There are one (Patient initiated or Patient trigger) which begins by the intake effort of the patient, one (Time trigger) where the ventilation begins by the constant rhythm. Moreover, there are Pressure trigger, Flow trigger, Volume trigger in Patient trigger.
2. The corrugated adjustment during intake
The one (Pressure controlled or Pressure generator) which makes pressure the index of the control, the one (Flow controlled or Flow generator), equal "GAARI" which makes an intake flow the index of the control, this are decision "RU" with the difference of the control system of the driving-source.
3. The ending of intake
If saying that the airway pressure becomes a set value in the expression in the Pressure cycle( past which ends intake Pressure limit) , There is Flow cycle that intake gas ends when declining below the value with Time cycle to end intake at the constant intake time, Volume cycle that intake ends when reaching constant intake air quantity of ventilation (Tidal Volume), constant intake flow rate It may think that Pressure cycle and Flow cycle are Patient cycle for which it is easy to reflect the intention (or the respiratory-control condition) of the patient among these. If the intake flow rate is constant, it is Volume ventilation (Volume limit to say in the expression in the past) that Time cycle and Volume cycle are the same.
4. The control in the expiration
In the past, the exhalation breathing resistance and NEEP(Negative End Exipiratory Pressure) existed but at present, only PEEP(Positive End Expiratory Pressure) is clinically used.
B. The expression of the mode which is based on the tense classification
By classifying the mode of operation of each of these aspects, it is possible of the mode of the ventilation of the resuscitator to be specified, too. In this case, it expresses ventilation form in the difference of the control method of each aspect of (1)-(4).
For example, the controlled-respiration of Bea-3 if using ] type active-ventilation mode (sCMV/CMV, Assist/Control, and so on,) as an example is Time or Volume trigger, Flow control, Volume cycle and Servo-900 "NO" is Time or Pressure trigger, Flow control, Time cycle. Also, Bear-5 becomes Time or Pressure trigger, Flow control, Time cycle. However, because the control method is complicated about the recent equipment, it is necessary to be specified with Patient cycle(Pressure or Flow trigger), Pressure control, Flow or Pressure or Time cycle by Servo-300 even of PSV. By however, e.g. Pressure Regulated Volume Conrol Because it changes a ventilating-pressure every time it takes, even if it uses such an expression way, it is difficult to express the characteristic of the mode correctly and appropriately. The reason for being necessary so, too, is the cause why the this manual used the term of the manufacturer just as it is.
Incidentally, the ] type ventilation by the Japanese meant Volume Cycle Ventilation originally but at present, it becomes the concept to have contained the various quantity ventilation modes of sCMV, Volume Assisted Ventilation, Volume Control Ventilation "NADO", too. At the this manual, in the future, to avoid confusion, it generically calls and it expresses these with quantity ventilation (Volume Ventilation). Because the ] type ventilation, too, contains Pressure Control Ventilation, Pressure Support Ventilation, BIPAP in addition to Pressure Cycle ventilation, too, in the future, it expresses these with pressure ventilation (Pressure Ventilation).