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Updated: Jan 8, 2026

Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism
Published on: February 14, 2022
Negative pressure ventilator: advances in engineering, application and treatment
Chen Ma1, Huafeng Li2, Huajing Wan1
1Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China.
Introduction:
Negative Pressure Ventilation (NPV) offers a compelling, more physiological alternative to conventional positive pressure ventilation (PPV). By mimicking natural breathing dynamics, NPV inherently reduces the potential for ventilator-induced lung injury (VILI). Despite its mid-20th-century decline due to bulkiness, recent technological advancements have fueled a substantial resurgence of interest in its therapeutic applications.
Areas Covered:
This narrative review traces the historical evolution and modern advancements in negative pressure ventilators. The literature search was conducted using databases such as PubMed and Web of Science, with key terms including 'negative pressure ventilation,' 'iron lung,' 'cuirass ventilator,' 'Exovent,' and 'ventilator-induced lung injury.' It included peer-reviewed research and reviews in English and Chinese up to September 2024, aiming to provide comprehensive context by emphasizing recent advances while encompassing foundational studies.
Expert Opinion:
NPV is an underutilized modality with significant potential to limit VILI and improve hemodynamic stability, especially in niche clinical scenarios. Future translational success depends on addressing three key hurdles: enhancing portability, ensuring a robust body-seal, and achieving precise man-machine synchronization. With continued innovation and clinical validation, NPV is poised for broader adoption in both intensive care and remote settings.
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