Assisting ventilation in respiratory failure by negative pressure ventilation and by rocking bed

The present study was undertaken to evaluate the effectiveness of acute ventilation by rocking bed (RB) and by negative-pressure ventilator (NPV) on arterial oxygenation and carbon dioxide tension in seven patients in whom respiratory failure (PaCO2 [+/- SD], 64 +/- 4 mm Hg; PaO2, 54 +/- 10 mm Hg) was consequent on nonobstructive ventilatory impairment. The increase in SaO2 (percent above baseline, 5 percent RB and 6 percent NPV) was similar for both methods, but a greater fall in PCO2 (percentage change in PCO2, 3 percent RB; 15 percent NPV; p less than 0.05) was observed during NPV. Diaphragmatic and accessory muscle electrical activity was markedly reduced during NPV but remained unchanged or increased on RB. Asynchronous breathing was frequently observed with RB but only rarely with NPV. These preliminary results suggest that effective mechanical ventilatory support could be achieved with either RB or NPV. However, their long-term effects as compared with those of positive-pressure ventilation remain to be explored.