44:
252:. It used pressure from a tank of compressed oxygen to operate a valve system that alternately forced air into and out of a person's airway, using alternating positive and negative air pressure. Although portable, and able to be used by lay persons and non-medical emergency responders, some medical personnel criticized it as dangerous (in part due to the risks of barotrauma or vomiting) and inefficient.
201:, also known as the tank ventilator, Drinker tank or Emerson tank, was the first common pure-NPV device when it was developed in the 1920s by Drinker, Shaw and Mason. It is a large, sealed horizontal cylinder (or "tank") in which the patient lies, with their head protruding from a sealed opening at one end of the tank. An air pump or a flexible
205:(usually motor-driven) varies the air pressure inside the tank, in continuous alternations, lowering and raising the air pressure in the cylinder. This causes the patient's chest to rise and fall, stimulating inhalation and exhalation through the patient's nose and mouth (which are outside the cylinder, exposed to ambient air pressure).
124:, or excess airway secretions), and in children. Continuous external negative pressure ventilation (CENPV) was found in a 2015 study to " oxygenation under physiological conditions", concurrent with lower "airway," "transpulmonary," and "intra-abdominal" pressures, than experienced with continuous
97:
Research and developments in artificial ventilation, both negative-pressure and positive-pressure, result in evolving assessments of the benefits and hazards of negative-pressure ventilators (NPVs). Different researchers and clinicians have made varying assessments, over time, about the primary
234:
The jacket ventilator, also known as a poncho or raincoat ventilator, is a lighter version of the iron lung or the cuirass ventilator, constructed of an airtight material (such as plastic or rubber) arranged over a light metal or plastic frame, or screen, and depressurized and repressurized by a
213:
The cuirass ventilator, also known as the chest shell, turtle shell or tortoise shell, is a more compact variation of the iron lung which only encloses the patient's torso and is sealed around their neck and waist, and depressurized and repressurized by an external pump or portable ventilator.
738:, LĂĽbeck, Germany (original manufacturers of the Pulmotor, and many other ventilation items, to the present day) (a lengthy, illustrated history of the development of artificial ventilation, interwoven with the publishers' own apparently self-promotional corporate history).
64:, assisting (or forcing) inhalation. When negative pressure is released, the chest naturally contracts, compressing the lungs, causing exhalation. In some cases, positive external pressure may be applied to the torso to further stimulate exhalation.
50:
cylinder (black), patient head exposed through sealed opening. Diaphragm (yellow) mechanically extends, and then retracts, varying cylinder air pressure and causing the patient's chest to expand (top), and then contract
689:, "Early Positive and Alternate Pressure Machines" in "An Anesthesiologist’s Perspective on the History of Basic Airway Management: The 'Progressive' Era, 1904 to 1960," submitted May 27, 2017, published February 2018,
59:
in the diagram), the negative pressure is applied to the patient's torso, or entire body below the neck, to cause their chest to expand, expanding their lungs, drawing air into the patient's lungs through their
116:) They are effective for various conditions, especially neuromuscular and skeletal disorders, particularly for long-term night-time ventilation. They are effective in patients who have severe
465:
Jackson, Christopher D., MD, Dept. of
Internal Medicine, and Muthiah P Muthiah, MD, FCCP, D-ABSM, Assoc. Prof. of Medicine, Div. of Pulmonary / Critical Care / Sleep Medicine,
729:
553:
140:
NPVs do not work well if patient's lung compliance is decreased, or their lung resistance is increased. They result in a greater vulnerability of the airway to
709:
470:
647:
654:
retrieved April 11, 2020 (note detailed reader comment, , April 7, 2020, by
Christopher Smith, with clinical application details.)
345:
513:
623:
129:
88:
112:
75:
to pump air into their lungs (inhale under positive pressure), then suck it back out (exhale under negative pressure).
488:
83:
Negative pressure ventilators, while widely used in the early-to-mid 20th
Century (particularly for victims of the
440:
756:
152:. The device is not portable and its installation may be difficult. Patients must sleep in a supine position.
621:
Walkey, Allan M.D. and Ross Summer M.D., "Negative pressure" in "E. Noninvasive
Mechanical Ventilation," in
609:
604:
473:
April 11, 2019, Medscape, retrieved April 12, 2020 (short summary of iron history and technology, with photo)
383:
202:
125:
72:
390:, retrieved April 11, 2020 (historical background and images, explanatory diagrams, and live demonstrations)
222:
The exovent is a modern device similar to the cuirass ventilator, but developed in 2020, in response to the
751:
576:
414:
148:
or swallowed liquids, than with intermittent positive pressure ventilation. They exacerbate obstructive
666:
94:
However, researchers and clinicians still find some uses for NPVs, owing to their specific advantages.
35:
by periodically applying negative air pressure to their body to expand and contract the chest cavity.
509:
691:
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466:
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298:
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28:
581:
530:"The Return of the Pulmotor as a 'Resuscitator': A Back-Step toward the Death of Thousands,"
120:, impaired consciousness, are unable to tolerate a facial mask (due to facial deformity, or
716:(picture of jacket ventilator ("poncho"), and other information.), retrieved April 12, 2020
599:
417:
141:
117:
8:
685:
School of
Medicine & Public Health, William S. Middleton Memorial Veterans Hospital,
248:
The
Pulmotor is a device developed in the early 1900s which was the forerunner of modern
735:
559:
686:
294:
110:(a measure of the lungs' ability to expand and contract).(1988: Grum & Morganroth,
441:"How Does Iron Lung Work?: Polio Survivor, 82, Among Last to Use Breathing Equipment,"
630:
534:
223:
303:
106:
Generally, NPVs are best with patients who have neuromuscular diseases, but normal
421:
107:
600:"Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDS"
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287:
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170:
Cuirass ventilator, also known as a chest shell, turtle shell or tortoise shell;
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71:) is placed at the patient's airway, and alternates negative pressure with
471:"What is the background of the iron lung form of mechanical ventilation?,"
427:
299:"Non-invasive and domiciliary ventilation: negative pressure techniques,"
149:
672:
476:
452:
731:
It began with the
Pulmotor: One Hundred Years of Artificial Ventilation
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555:
It began with the
Pulmotor: One Hundred Years of Artificial Ventilation
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91:, which force air (or oxygen) directly into the patient's airway.
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jacket ventilator, also known as a poncho or raincoat ventilator;
657:
167:, also known as a tank ventilator, Drinker tank or Emerson tank;
608:
2015; 2015: 714902. Published online July 28, 2015, from NCBI,
61:
615:
548:
546:
544:
145:
238:
98:
positive and negative aspects of NPVs. A sampling includes:
648:"Modern iron lung designed to address ventilator shortage,"
562:, LĂĽbeck, Germany (original manufacturers of the Pulmotor).
541:
382:, video (8 minutes), January 11, 2016, OPENPediatrics and
598:
Raymondos, Konstantinos; Jörg Ahrens; Ulrich
Molitoris:
573:"Negative-pressure ventilation: is there still a role?,"
525:
523:
521:
132:(ARDS) patients, possibly reducing high ARDS mortality.
699:
489:"1907: The first mechanical ventilator: The Pulmotor,"
518:
293:
Shneerson, Dr. John M., Newmarket
General Hospital, (
344:Grum, Cyril M., MD, and Melvin L. Morganroth, MD,
743:
667:"The 'iron lung' and the modern 'ventilation',"
308:1991;46: pp.131-135, retrieved April 12, 2020
160:There are several types of NPVs, including:
239:Positive-and-negative pressure ventilator
67:Another form of NPV device (such as the
42:
301:#5 of series "Assisted ventilation" in
744:
532:by Yandell Henderson, December 1943,
514:Wood Library-Museum of Anesthesiology
469:College of Medicine-Memphis, et.al.,
354:1988;3:6-20, retrieved April 12, 2020
208:
346:"Initiating Mechanical Ventilation,"
229:
89:Positive-pressure airway ventilators
130:Adult respiratory distress syndrome
13:
669:Oxy.gen, retrieved April 11, 2020
113:Journal of Intensive Care Medicine
14:
768:
723:
624:Boston Medical Center ICU Manual
424:, U.K., retrieved April 11, 2020
155:
135:
31:that stimulates an ill person's
708:by medical device manufacturer
635:p.17, retrieved April 12, 2020.
580:2002, 20: pp.187-197;, also in
87:), are now largely replaced by
736:Dräger Medical AG & Co. KG
560:Dräger Medical AG & Co. KG
495:blog, retrieved April 12, 2020
38:
1:
734:by Ernst Bahns, published by
610:National Institutes of Health
605:Case Reports in Critical Care
255:
126:positive pressure ventilation
101:
577:European Respiratory Journal
186:
21:negative pressure ventilator
7:
612:, retrieved April 12, 2020.
243:
10:
773:
571:Corrado, A.; Gorini, M.:
384:Boston Children's Hospital
380:"The Iron Lung and Polio,"
217:
190:
55:In most NPVs (such as the
681:Matioc, Adrian A., M.D.,
584:retrieved April 17, 2020
449:retrieved April 11, 2020
295:Newmarket, Suffolk, U.K.
144:, such as inhalation of
78:
683:University of Wisconsin
351:Intensive Care Medicine
757:Mechanical ventilation
250:mechanical ventilators
52:
378:Rockoff, Mark, M.D.,
235:portable ventilator.
46:
29:mechanical ventilator
418:Science Museum Group
128:(CPPV), in study of
118:respiratory acidosis
752:Respiratory therapy
710:Dima Italia S.r.l.
687:Madison, Wisconsin
650:, April 06, 2020,
510:"Draeger Pulmotor"
467:Univ. of Tennessee
209:Cuirass ventilator
53:
16:Medical technology
631:Boston University
443:August 21, 2018,
230:Jacket ventilator
224:COVID-19 pandemic
73:positive pressure
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491:April 19, 2017,
487:Bottrell, John,
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415:"The Iron Lung,"
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108:lung compliance
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85:Polio epidemics
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27:) is a type of
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724:External links
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714:Bologna, Italy
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696:Vol. 128, No 2
692:Anesthesiology
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150:sleep apnea
39:Description
746:Categories
652:New Atlas,
256:References
142:aspiration
102:Advantages
706:"Poncho,"
203:diaphragm
199:iron lung
193:Iron lung
187:Iron lung
165:Iron lung
57:iron lung
48:Iron lung
33:breathing
446:Newsweek
244:Pulmotor
180:Pulmotor
173:exovent;
69:Pulmotor
51:(bottom)
535:Science
388:YouTube
218:Exovent
628:2008,
304:Thorax
62:airway
602:, in
146:vomit
79:Usage
197:The
712:of
582:PDF
386:on
348:in
297:),
25:NPV
748::
674:^
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19:A
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23:(
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