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Negative pressure ventilation via chest cuirass to decrease ventilator-associated complications in infants with acute
1Department of Pediatric Critical Care Medicine, Duke Children's Hospital, Durham, North Carolina, USA.
Insights
Negative pressure ventilation using a chest cuirass can minimize complications associated with invasive positive pressure ventilation in critically ill infants. This noninvasive method improved patient condition and reduced the need for more invasive therapies.
Area of Science:
- Pediatric critical care medicine
- Respiratory support technologies
- Noninvasive ventilation strategies
Background:
- Invasive positive pressure ventilation (IPPV) is associated with significant pulmonary and nonpulmonary complications.
- Noninvasive ventilation (NIV) strategies can mitigate many IPPV-related complications.
- Negative pressure ventilation (NPV), a form of NIV, has historical precedent for successful application.
Observation:
- Three critically ill infants received NPV via a chest cuirass at two institutions.
- The application of chest cuirass ventilation aimed to prevent or reduce complications from IPPV.
- NPV was utilized as an alternative or adjunct to IPPV.
Findings:
- Chest cuirass ventilation demonstrated clinical improvement in all three infant cases.
- The use of NPV decreased the requirement for more invasive respiratory support.
- NPV effectively managed respiratory needs, reducing the burden of IPPV.
Implications:
- These case reports highlight the potential of NPV with a chest cuirass in pediatric critical care.
- Further clinical studies are warranted to validate the efficacy and safety of chest cuirass NPV.
- NPV may offer a valuable alternative for respiratory support in specific infant populations, minimizing IPPV risks.
Abstract:
Pulmonary and nonpulmonary complications of invasive positive pressure ventilation are well documented in the medical literature. Many of these complications may be minimized by the use of noninvasive ventilation. During various periods of medical history, negative pressure ventilation, a form of noninvasive ventilation, has been used successfully. We report the use of negative pressure ventilation with a chest cuirass to avoid or decrease the complications of invasive positive pressure ventilation in three critically ill infants at two institutions. In each of these cases, chest cuirass ventilation improved the patient's clinical condition and decreased the requirement for more invasive therapy. These cases illustrate the need for further clinical evaluation of the use of negative pressure ventilation utilizing a chest cuirass.