Beyond Knobology: A Clinical Flight Simulator for Ventilator Management Training
An interview with Dr.-Ing. Stefan Frembgen, President of IngMar Medical
How did IngMar Medical get involved in ventilator management training?

Before establishing IngMar Medical in 1993, I worked in the ventilator industry. IngMar Medical’s flagship product, the ASL 5000™ Breathing Simulator was originally designed for the respiratory device research and engineering community. It has indeed established itself as an essential tool in R&D departments of all major ventilator manufacturers.
However, the ASL 5000’s unique ability to simulate spontaneous breathing in the whole range of patients encountered in the ICU and NICU made it an excellent tool for teaching about managing patients on the more advanced modes available with modern ICU ventilators. Recognizing this, we set out to create a unique system to leverage the power of the ASL 5000 for teaching ventilator management.
Why is there a need for ventilator management training?
At the recent AAMI/FDA Summit on Ventilator Technology, the call for more extensive and consistent training was repeated over and again. A quarter century after the advent of graphics on ICU ventilators, it cannot be said that the potential of this tool is fully understood nor routinely applied. While new modes enable better treatment, they do not necessarily make ventilator management easier. The plethora of names for modes and the lack of user interface standardization create confusion.
This points to the need for a significantly increased depth of education in the art of ventilator graphics interpretation, and the diagnostic and caregiver skills to match. Let us make no mistake: In order to significantly improve outcomes for patients critically impaired in their ability to breathe, more resources, both time and financial, need to be dedicated to teaching the art of ventilator management. Simulation, if done in an efficient way, has the potential to give maximum results with manageable allocation of resources.
What do you mean by efficiency?
Efficiency, from the perspective of an educator, has many aspects:
- Minimum time to prepare high-impact learning materials and cases
- Well thought-out integration of simulation sessions into an overall curriculum covering relevant topics of ventilator management
- Flexibility to adapt materials and scenarios to the level of the students being taught
The RespiSim® System has been designed with all these requirements in mind. It enables the creation of different types of patients and disease states within curriculum designed by leading educators around ventilator management.
Can the RespiSim System be used for competency testing?
The System can be used to simulate nearly any respiratory patient on any ventilator in any mode and to even record data from a multitude of ICU ventilators directly. It is a tool for education as well as for competency testing.
What is IngMar Medical’s vision for RespiSim?
We would like to give educators a “clinical flight simulator” to enable efficient, immersive learning and competency testing to improve patient outcomes. Another part of our vision for the RespiSim System includes facilitating collaboration within the respiratory care community resulting in time savings for instructors, more consistent training, higher skill levels, and ultimately better patient care.