Classify ventilation status into InvasiveVent, NonInvasiveVent, HFNC, SupplementalOxygen, Tracheostomy, or None from charting data. Use for ventilation duration analysis, respiratory support characterization, or as a component of severity scores (SOFA respiratory, OASIS).
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name
ventilation-classification
description
Classify ventilation status into InvasiveVent, NonInvasiveVent, HFNC, SupplementalOxygen, Tracheostomy, or None from charting data. Use for ventilation duration analysis, respiratory support characterization, or as a component of severity scores (SOFA respiratory, OASIS).
tier
validated
category
clinical
Ventilation Classification
Classifies each ICU charting observation into a ventilation status category and groups consecutive observations into ventilation episodes. This concept is used directly by SOFA (respiratory component requires mechanical ventilation for scores 3-4), OASIS, and many other severity scores and research definitions.
M4Bench Use
In M4Bench, target concept tables listed in the task configuration are removed or unavailable in the agent database. Use this skill as procedural guidance and derive the requested output from available source or intermediate tables; do not rely on a precomputed target table or bundled SQL script.
When to Use This Skill
Determining ventilation type and duration for ICU stays
SOFA respiratory scoring (requires knowing if patient is on invasive mechanical ventilation)
Weaning studies (tracking transitions between ventilation modes)
Respiratory support characterization in cohort studies
Any task requiring classification of oxygen delivery or ventilator data
Ventilation Categories
Category
Description
Examples
Tracheostomy
Patient has a tracheostomy tube
Tracheostomy tube, Trach mask
InvasiveVent
Invasive mechanical ventilation via endotracheal tube or ventilator mode
Endotracheal tube, CMV, SIMV, PRVC/AC, VOL/AC, etc.
NonInvasiveVent
Non-invasive positive pressure ventilation
BiPAP mask, CPAP mask, NIV modes
HFNC
High-flow nasal cannula
High flow nasal cannula
SupplementalOxygen
Low-flow or standard oxygen delivery
Nasal cannula, Non-rebreather, Face tent, Venti mask
None
No supplemental oxygen (room air)
None
Classification Priority
When multiple indicators are present simultaneously, the classification follows this priority (highest first):
Tracheostomy — o2_delivery_device_1 is 'Tracheostomy tube' or 'Trach mask '
InvasiveVent — o2_delivery_device_1 is 'Endotracheal tube' OR any invasive ventilator mode present
NonInvasiveVent — o2_delivery_device_1 is 'Bipap mask ' or 'CPAP mask ' OR Hamilton NIV modes
HFNC — o2_delivery_device_1 is 'High flow nasal cannula'
SupplementalOxygen — Other oxygen delivery devices
None — o2_delivery_device_1 is 'None'
Classification Rules
By Oxygen Delivery Device (o2_delivery_device_1)
Device Value
Category
'Tracheostomy tube'
Tracheostomy
'Trach mask '
Tracheostomy
'Endotracheal tube'
InvasiveVent
'Bipap mask '
NonInvasiveVent
'CPAP mask '
NonInvasiveVent
'High flow nasal cannula'
HFNC
'Non-rebreather'
SupplementalOxygen
'Face tent'
SupplementalOxygen
'Aerosol-cool'
SupplementalOxygen
'Venti mask '
SupplementalOxygen
'Medium conc mask '
SupplementalOxygen
'Ultrasonic neb'
SupplementalOxygen
'Vapomist'
SupplementalOxygen
'Oxymizer'
SupplementalOxygen
'High flow neb'
SupplementalOxygen
'Nasal cannula'
SupplementalOxygen
'None'
None
Note: Some device values have trailing spaces (e.g., 'Trach mask ', 'Bipap mask ', 'Venti mask '). These must be matched exactly.
Individual charting observations are grouped into ventilation episodes using these rules:
New episode starts when:
First observation for a stay (no previous observation)
Gap of >= 14 hours between consecutive observations of the same status
Ventilation status changes from previous observation
Episode boundaries:
starttime = earliest charttime in the episode
endtime = latest charttime in the episode (or the next observation's charttime if it's within 14 hours)
Single-observation episodes (starttime == endtime) are excluded
14-hour gap rule: If two consecutive observations of the same ventilation status are more than 14 hours apart, they are treated as separate episodes. This prevents spanning overnight gaps where ventilation may have been discontinued and restarted.
Required Tables for Custom Calculation
Raw Mode (from chartevents directly)
Ventilator settings — itemids from mimiciv_icu.chartevents:
224688: Respiratory Rate (Set)
224689: Respiratory Rate (spontaneous)
224690: Respiratory Rate (Total)
224687: Minute Volume
224684: Tidal Volume (set)
224685: Tidal Volume (observed)
224686: Tidal Volume (spontaneous)
224696: Plateau Pressure
220339, 224700: PEEP
223835: Inspired O2 Fraction (FiO2)
223849: Ventilator Mode
229314: Ventilator Mode (Hamilton)
223848: Ventilator Type
224691: Flow Rate
Oxygen delivery — itemids from mimiciv_icu.chartevents:
223834, 227582: O2 Flow
227287: O2 Flow (additional)
226732: O2 Delivery Device
For classification, the critical itemids are:
223849 (Ventilator Mode) — text value maps to InvasiveVent
229314 (Ventilator Mode Hamilton) — text value maps to InvasiveVent or NonInvasiveVent
226732 (O2 Delivery Device) — text value maps to all categories
Critical Implementation Notes
Trailing Spaces in Device Names: Several o2_delivery_device_1 values have trailing spaces (e.g., 'Trach mask ', 'Bipap mask ', 'Venti mask ', 'Medium conc mask '). These must be matched exactly as stored in MIMIC-IV.
Priority of Device over Mode: Tracheostomy and Endotracheal tube (from o2_delivery_device_1) take priority over ventilator mode classification. A patient on a tracheostomy with a ventilator mode set is classified as Tracheostomy, not InvasiveVent.
CPAP/PSV Modes Are Invasive: In MIMIC-IV charting conventions, CPAP/PSV and related modes (CPAP/PPS, CPAP/PSV+ApnPres, etc.) are recorded as ventilator modes on patients with endotracheal tubes. These are classified as InvasiveVent, not NonInvasiveVent. Non-invasive CPAP is identified by the CPAP mask device, not the ventilator mode.
Hamilton vs Standard Modes: MIMIC-IV has two ventilator mode columns — ventilator_mode (standard ventilators) and ventilator_mode_hamilton (Hamilton ventilators). These are combined with COALESCE for classification purposes.
Single-Observation Episodes Excluded: Episodes where starttime equals endtime are filtered out. This removes transient or erroneous observations that don't represent sustained ventilation periods.
NULL Ventilation Status Excluded: Observations that don't match any classification rule produce NULL status and are excluded from episode detection.
LAG Partitioning: The gap detection LAG function partitions by (stay_id, ventilation_status) — not just stay_id. This means the 14-hour gap rule applies within each status category separately.
References
Johnson AEW et al. "MIMIC-IV, a freely accessible electronic health record dataset." Scientific Data. 2023;10(1):1.
