1 - History of Mechanical Ventilation

early history of mechanical ventilation (MV)

• 800 BC

prophet Elisha rescues child via rudimentary resuscitation techniques

early history of mechanical ventilation (MV)

• 460-322 BC

• Hippocrates first wrote directions for ET tubes

• Aristotle showed air is important for life by putting small animals into boxes causing death

early history of mechanical ventilation (MV)

• AD 200

Galen (Greek physician) studied dogs, apes, and cows and concluded their anatomies are similar to humans

early history of mechanical ventilation (MV)

• 1493-1541

Paracelsus performed first recorded MV using bellows

early history of mechanical ventilation (MV)

• 1635-1703

Robert Hooke used bellows during animal surgery

history of resuscitation

• 1744

John Fothergill promoted mouth-to-mouth ventilation

history of resuscitation

• 1767

“Society for Drowned Persons” founded in Holland

recommendations:

• mouth-to-mouth ventilation

• induce warmth

• compress chest and stomach

• blow tobacco smoke into rectum and bowels (!)

• bleed jugular (!)

• induce vomiting/sneezing

history of resuscitation

• 1911

Dräger® invents first true MV machine: “Pulmotor”

• patients head in sniffing position

• powered by compressed gas cylinder

• hold pressure on cricoid cartilage

examples of negative pressure MV

• iron lung (whole body)

  • used extensively during polio epidemic; last person to use one died in 2024!

• chest cuirass (chest only)

  • still in use today for neuromuscular disorders, normal lungs, and secretion removal

early examples of positive pressure MV

• Engstrom®

• Lundi®

• Brag®

Bennett valve

machine that delivers high pressure for inhalations and normal pressure for exhalations

first microprocessor MV machine

PB 7200

MV basic settings

• controls

• mode (volume/pressure control)

• V_T

• RR or f

• flow rate (PIFR)

• F_iO₂

• PEEP

• sensitivity

• humidifiers

• temperature

MV basic settings

• alarms

• high/low pressure

• high/low PEEP

• volume (V_T or V_E)

• source gas

• I:E ratio

• apnea

• ventilator failure

MV basic settings

• other

• ramp

• inspiratory/expiratory hold

• expiratory retardation