DAIL C W, AUSTIN E, HUDDLESTON O L, BOWER A G
Calif Med. 1951 Jul;75(1):15-25.
As the first step in an attempt to clarify criteria for use of the rocking bed rather than the respirator as an aid to breathing for patients with weakness of respiratory muscle function caused by poliomyelitis, ventilation studies were done on seven patients with pronounced weakness or paralysis of the respiratory muscles. Average tidal air volume was considerably less when the patient was on the rocking bed than when he was in the respirator. Since the tidal air volume with the patient on the rocking bed represents the maximum that can be produced with the apparatus, whereas the volume in the respirator represents the patient's usual tidal air and the respirator is capable of a greater volume if necessary, it is apparent that in cases of complete paralysis of the respiratory muscles the respirator has a large margin of safety, the rocking bed none. From clinical observations made on 51 patients who were put upon the rocking bed-23 of them early in the course of the disease and 28 after they had been ill three months or more-it was concluded that the rocking bed is contraindicated for patients who are febrile and in whom the disease is progressing rapidly, and for those with atelectasis or urinary or pulmonary infection. It must be used with extreme care in the case of patients early in the course of the disease who are not tracheotomized, because of a tendency toward increased accumulation of mucus and the danger of atelectasis. General guides were developed with regard to use of the rocking bed for patients with post-acute poliomyelitis, and somewhat different rules were drawn for use of the apparatus in cases in which there is a chronic respiratory problem.The rocking bed will give artificial respiration in cases of respiratory weakness, but will not provide enough tidal air for the patient with paralysis of the muscles of respiration.
作为明确使用摇床而非呼吸器辅助脊髓灰质炎所致呼吸肌功能衰弱患者呼吸标准的第一步，对7例呼吸肌明显衰弱或麻痹的患者进行了通气研究。患者在摇床上时的平均潮气量明显低于在呼吸器中时。由于患者在摇床上时的潮气量代表该装置所能产生的最大值，而在呼吸器中的潮气量代表患者通常的潮气量，且必要时呼吸器能够提供更大的气量，显然在呼吸肌完全麻痹的情况下，呼吸器有很大的安全余量，而摇床则没有。根据对51例使用摇床患者的临床观察——其中23例在疾病早期使用，28例在患病三个月或更长时间后使用——得出结论，发热且疾病进展迅速的患者、有肺不张或泌尿系统或肺部感染的患者禁忌使用摇床。对于疾病早期未行气管切开术的患者，使用摇床时必须极其谨慎，因为有黏液积聚增加的趋势和肺不张的危险。针对急性后期脊髓灰质炎患者使用摇床制定了一般指南，对于存在慢性呼吸问题的情况，使用该装置制定了略有不同的规则。摇床可在呼吸衰弱的情况下进行人工呼吸，但对于呼吸肌麻痹的患者无法提供足够潮气量。
