Negative-Pressure Ventilation

Grasso, Rosario Francesco; Engelberts, Doreen; Helm, Emma; Frndova, Helena; Jarvis, Steven; Talakoub, Omid; McKerlie, Colin; Babyn, Paul; Post, Martin; Kavanagh, Brian P.

doi:10.1164/rccm.200707-1004oc

Cited by 64 publications

(55 citation statements)

References 26 publications

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“…These effects may be caused by the different way in which ventilator pressures are applied, resulting in a much more effective means of distending the lungs and maintaining lung volumes, as the negative pressure acts across a broad surface of both the chest wall and abdomen. Therefore, in both surfactant-depleted rabbits and patients with ARDS, at matched end-expiratory and inspiratory lung volumes, applying lower transpulmonary pressures, CENPV presumably also resulted in better oxygenation as compared to CPPV [7, 8]. …”

Section: Discussionmentioning

confidence: 99%

“…During CENPV, regional pleural pressure gradients probably exhibit a substantially different development compared with those in CPPV [7, 8]. Furthermore, transpulmonary pressures (TPP = alveolar pressure minus esophageal pressure), involved in both ventilator modes, should be cumulative when CENPV is combined with CPPV.…”

Section: Discussionmentioning

confidence: 99%

“…This unacceptably high mortality rate calls for alternative techniques that substantially differ from the present methods. CENPV might be worth considering as an alternative, as it has proven less injurious and resulted in better oxygenation in experimental lung injury [7] and also improved gas exchange in a physiologic study on patients with ARDS [8]. …”

Section: Discussionmentioning

confidence: 99%

“…This device was constructed drawing on our clinical experience with a tank respirator that was built in our hospital in the early 1980s [7]. Gull-wing doors at both sides and one at the head enabled rapid access to the intubated patient who was placed completely inside the chamber (Figure 3).…”

Section: Clinical Casementioning

confidence: 99%

“…According to observations of lung injury, it is not only spontaneous breathing under negative pressure that differs substantially from CPPV: this is certainly also the case for ventilation with negative pressure. Continuous external negative-pressure ventilation (CENPV) improves oxygenation under more physiological conditions with lower transpulmonary, airway, and intra-abdominal pressures than with CPPV [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

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Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDS

Raymondos

Ahrens

Molitoris

2015

Case Reports in Critical Care

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Objective. Tracheal intubation and positive-pressure ventilation as the current standard of care for the adult respiratory distress syndrome (ARDS) seem to have reached their limit in terms of a further relevant reduction of the still very high mortality. Case Presentation. A 75-year-old male patient developed ARDS after abscess drainage with deteriorating oxygenation, despite positive end-expiratory pressure (PEEP) values above 15 cm H2O. We applied external negative-pressure ventilation with a chamber respirator using −33 cm H2O at inspiration and −15 cm H2O at expiration, combined with conventional pressure support using a PEEP of about 8 cm H2O and a pressure support of 4–12 cm H2O. Alveolar infiltrates disappeared rapidly and PaO2/FiO2 values surpassed 300 mmHg after the first application and 500 mmHg after the second. Negative-pressure ventilation was used for 6–18 hours/day over five days. Now, 13 years later, the patient is still alive and has a good quality of life. Conclusion. Using this or similar concepts, not only in intubated patients but also as a noninvasive approach in patients with ARDS, offers new options that may genuinely differ from the present therapeutic approaches and may, therefore, have the potential to decrease the present high mortality from ARDS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Clinical Casementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDS

Raymondos

Ahrens

Molitoris

2015

Case Reports in Critical Care

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Electromagnetic ventilation: First evaluation of a new method for artificial ventilation in humans

et al. 2010

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Current methods of artificial ventilation cannot prevent diverse problems associated with mechanical ventilation. In contrast to all current forms of mechanical ventilation, electromagnetic stimulation can activate respiratory muscles directly. However, it is not known if and to what extent electromagnetic stimulation can ventilate humans. In 10 volunteers we stimulated the lateral neck using magnetic stimulators. Over 63 s we stimulated nine times with a frequency of 25 HZ for 1.1 s using 600 V, 900 V, and 1,200 V. The minimum stimulation time for each volunteer was 9 min. A Capnomac monitor measured minute ventilation. Electromagnetic stimulation was well tolerated and safe. Bilateral stimulation with 600 V achieved considerable minute ventilation (median +/- SD, 7.2 +/- 3.4 L/min) that increased at higher voltage levels (P < 0.0001). 900 V achieved sufficient minute ventilation in all volunteers (11.5 +/- 5.0 L/min; 1200 V, 14.0 +/- 4.9 L/min). This first evaluation of electromagnetic ventilation demonstrates that it can be used to ventilate humans sufficiently. This method may be developed to a new mode of ventilation.

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