Biphasic cuirass ventilation

The cuirass ventilation ( cuirass ventilator, . Engl biphasic cuirass ventilation, BCV ) is a tool in the home ventilation and respiratory support. As the historic iron lung is a noninvasive method. Through external vacuum in a comprehensive chest cuirass (French cuirasse " leather armor", from cuir ' leather ' ) of the chest is expanded (non- invasive negative pressure ventilation, NINPV ).

Areas of application

The Cuirass Ventilation is not a method of acute intensive care, but serves the long -term ventilatory support in patients who can not provide sufficient ventilation of their lungs without tools. The principle of external negative pressure ventilation represents an alternative to the also non-invasive mask ventilation with positive airway pressures; they found a certain spread about in the spinal muscular atrophy. These respiratory support is a therapeutic option structurally related mainly in childhood. However, it does not represent a routine procedure, much more widespread too, is to mask ventilation. A comparison of the two methods is not possible due to the trial position.

The external negative pressure ventilation has the advantage that it is modeled on the physiological respiration, and not blowing air into the lungs, by pressure, but produced by expansion of the chest a vacuum in the lung, which leads to the fact that air flows passively into the lungs. Furthermore, nose and throat also during ventilation are freely accessible, so that eg the aspiration of mucus is easily possible. Disadvantages are the volume of the compressor, which partially met 50 dB, as well as created by the cuirass pressure points on the thorax and abdomen.

Design of the device

The cuirass ventilation is practiced by a vest type consisting of a transparent, relatively resilient material. It surrounds the chest and sometimes the patient's abdomen and followed on from the edges as closely as possible, so that no major leaks occur. A tube which is connected to the jacket, air can be pumped in and out thereto. A connected to the hose compressor takes over this pumping function.

Operation

The cuirass ventilation can be performed in different modes. By the compressor can be produced either in the cuirass a constant negative pressure; or a vacuum, the cyclically alternating with ambient pressure; or alternately under and over pressure for inspiration and Exspirationsunterstützung. Overpressure in the Cuirass of the chest is compressed at low pressure it expands. The so- induced changes in the thorax and lung volume respectively lead to an inhalation and exhalation and thus to the ventilation of the lungs. Through a connected control unit, various parameters can be set, the most important are the pressure limits at In-/Exspiration and respiratory rate. The vest can be used to either produce almost permanently or for example only during the sleep phases. Often enough use the fan from at night to avoid nocturnal apnea and the associated arousals ( arousals ).