Linton D M
Medical Intensive Care Unit, Department of Medicine, Hadassah University Hospital, Jerusalem, Israel.
Crit Care Resusc. 2005 Mar;7(1):22-8.
This review highlights the development and application of modern chest wall cuirass ventilators.
Initial animal studies and subsequent publications of applications of various modes of noninvasive cuirass ventilation are recorded.
Use of the modern cuirass ventilator in continuous negative, intermittent negative or biphasic (negative and positive) modes is described. Techniques of synchronisation of the cuirass ventilation to the patient's inspiratory and expiratory demands, or even to the patient's cardiac cycle are described. Use of noninvasive cuirass ventilation at normal physiological respiratory rates and at high frequency is highlighted in published studies and in the authors' clinical practice in intensive care. Case reports of patients with cardiac, respiratory and neurological diseases having been successfully managed are used in the review to highlight the desirability, versatility and safety of noninvasive cuirass ventilation for optimal patient care in selected cases.
Cuirass ventilation is a valid and valuable method of ventilation in a subset of patients as illustrated by the case reports in this review. Future possibilities for the use of noninvasive cuirass ventilation including in emergency situations where expertise for endotracheal intubation is unavailable; or where physicians or paramedics are unlikely to be able to intubate unconscious/paralysed patients quickly enough to save their lives (e.g. in biological or chemical warfare situations).
本综述重点介绍现代胸壁护胸式呼吸机的发展与应用。
记录了最初的动物研究以及随后关于各种无创护胸式通气模式应用的出版物。
描述了现代护胸式呼吸机在持续负压、间歇负压或双相（负压和正压）模式下的使用情况。阐述了使护胸式通气与患者吸气和呼气需求，甚至与患者心动周期同步的技术。已发表的研究以及作者在重症监护临床实践中强调了在正常生理呼吸频率和高频情况下使用无创护胸式通气。本综述中使用了成功治疗心脏、呼吸和神经疾病患者的病例报告，以突出无创护胸式通气在特定病例中为实现最佳患者护理的可取性、多功能性和安全性。
如本综述中的病例报告所示，护胸式通气对于一部分患者是一种有效的且有价值的通气方法。无创护胸式通气未来的应用可能性包括在无法进行气管插管专业操作的紧急情况下；或者在医生或护理人员不太可能足够迅速地为昏迷/瘫痪患者插管以挽救其生命的情况下（例如在生物或化学战情形中）。
