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First designed in the 19th century and used extensively from 1929 onwards, Negative Pressure Ventilators have been successful in human healthcare with widescale use during the Polio epidemic 70 years ago. Negative Pressure Ventilation was recognised and viewed positively by clinicians and patients. The benefits are well-documented in historic published papers.

Although given the nickname ‘iron lung’, the term is misleading as multiple subsequent lighter NPV devices were developed from lightweight materials.

The core technology which has a century of evidence for its safety and function. It is an ideal candidate to be revitalised with modern materials, design, and control mechanisms, to support the growing need for non-invasive ventilatory support.

As knowledge about pneumonia and other respiratory diseases increase, clinicians world-wide have expressed concern about some patients developing possible lung damage from positive pressure ventilation.

Read on for a full narrative review on the history of 'the iron lung' told by our own Professor David Howard, Malcolm Coulthard, Colin Speight, and Michael Grocott.

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The History of Negative Pressure Ventilation


Negative Pressure Ventilation for Respiratory Failure: A Phoenix from the Ashes?

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Figure 1: AE Jones produced a similar design to Dalziel in 1864 in the USA. He treated asthma and bronchitis with this device.

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Figure 2: Von Hauke’s tank respirator, 1876.

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Figure 3: Woillez’s tank respirator, the Spirophore 1876.

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Figure 4: Eisenmenger’sfirsthand-operatedportableventilator,1901.A motorized version was subsequently produced.

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 Figure 5: Dr Rudolf Eisenmenger’s cuirass (1904) reproduced by kind permission of the Editor of the Lancet.

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Figure 6: The first iron lung powered by electricity, designed by engineer Phillip Drinker, Charles McKhann, a paediatrician and Louis Shaw, a physiologist,1928.

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Figure 7: Both Portable cabinet respirator, made with plywood,1937.