History of Ventilators

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Ventilators are machines that can help patients breathe, or, in some cases, breathe for them. Doctors use ventilators on patients in very severe cases, when it is determined that the patient does not get enough oxygen from regular breathing or through increased oxygen supply. While on a ventilator, the patient’s lungs have the opportunity to start healing and receive much needed medications, until breathing can be restored. Ventilators are now a standard part of critical care and have significantly evolved in their technology over the last 100 years.

The earliest attempt to support breathing mechanically can be traced all the way back to the late 18th century. These early visions of ventilators relied on negative pressure that is also seen in the most widely used ventilation device of the 20th century, the iron lung (for more information on iron lungs visit https://www.futurity.org/ventilator-history-2335052/). During the polio epidemic of the early 20th century, children with paralyzed lungs were placed in these machines, which expanded and contracted to force air into and out of the lungs. This technique required a patient to be fully encased in the iron lung with only their head sticking out. In the 1960s, researchers started developing positive-pressure machines, which force air directly into the lung. This technology caught on fast, and nowadays all modern ventilators rely on positive pressure. These machines require the insertion of a tube into the patient’s trachea, while the patient is sedated (intubation), making them more invasive than negative pressure ventilators.

Modern mechanical ventilators are much more portable than their predecessors and provide many adjustable features that can facilitate air flow and adjust the pressure and rate according to the patient’s needs. The goal is to optimize the process for each patient, to ensure as much comfort as possible and have a better outcome. While they are generally computerized microprocessor-controlled machines, patients can also be ventilated with a simple hand-operated bag valve mask in case of emergency.

Given the importance of ventilators in hospitals, we expect that future developments will allow them to integrate even further with other components of critical care. This will likely be assisted by electronic means of communication between different bedside devices for a more efficient interaction. Other possible features are the incorporation of ventilator management protocols into the basic operation of the ventilator, displays with organized information instead of rows of unrelated data, and smart alarm systems. Doctors hope that these improvements will lead to better outcomes for the patient and a higher level of care.

(For a further depth study on the past, present, and future of ventilators visit: http://rc.rcjournal.com/content/56/8/1170)