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Ventilators do not breathe
  1. Colin J Morley1,2,
  2. Martin Keszler3
  1. 1Department of Neonatal Research, The Royal Women's Hospital, Melbourne, Australia
  2. 2Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge, UK
  3. 3Department of Pediatrics, Brown University, Women's and Infants’ Hospital of Rhode Island, Providence, Rhode Island, USA
  1. Correspondence to Professor Colin J Morley, 23 High Street, Great Shelford, Cambridge CB22 5EH, UK; colin{at}morleys.net

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In the traditional terminology of neonatal ventilation, the ventilator delivers breaths with a set inspiratory pressure and inspiratory time. Similarly, during neonatal resuscitation, the standard teaching is that a baby is ventilated with breaths, and if a T-piece device is used an inspiratory pressure is set on the device. The problem is that this terminology is inaccurate.

During our investigations of neonatal respiratory support and resuscitation, we have been interested in reporting how a baby's spontaneous breathing interacts with manual or ventilator inflations while being resuscitated or ventilated. We needed to find words to describe clearly the detailed interaction of a baby with the ventilator or resuscitation. We then realised the serious problems with the terminology used for ventilation and resuscitation. If we wrote about breaths, it was not clear to the reader whether this referred to the baby breathing or inflations by the ventilator or resuscitator. If we described the inspiratory time, readers might not know if this was the ventilator or baby. The words breath, inspiration and inspiratory are frequently misused and can easily be misinterpreted. Respiratory support is difficult to understand, even for experienced practitioners. Ambiguous or inaccurate terminology exacerbates this problem and hinders accurate communication. The interaction between the patient and …

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    Colin J Morley Martin Keszler