the incredibly, fascinating history of respiratory … invention of the mechanical ventilator (1743...
TRANSCRIPT
The Incredibly, Fascinating History of
Respiratory Therapy and
Mechanical Ventilation
Disclosures
Jack Emerson Dr. Forest BirdVivian Ray Bennett
Invasive(Need ETT or Trach)
Positive pressure ventilation
Negative pressure ventilation
Non-Invasive
Iron Lung/ Tank Ventilators
Jacket/Cuirass Ventilators
Volume Ventilators
Pressure Ventilators
A) Invention of the mechanical ventilator (1743 by Stephen Hales).
Stephen Hales (1677 – 1761)
Morton LT and Moore RJ, A Chronology of Medicine and Related Sciences, Brookfield: Scholar, 1997
In 1743, an English clergyman and physiologist named Stephen Hales invented the first mechanical ventilator.It operated through manual inflation of bellows which squeezed air into and out of the patients lungs.
Described by Alfred E. Jones of Lexington, Kentucky, in 1864.
Pneumatic Chamber
Iron lung / tank ventilation
Morton LT and Moore RJ, A Chronology of Medicine and Related Sciences, Brookfield: Scholar, 1997
• Designed to improve synchrony• This device was patented in
Germany with the ideal of creating perfect patient-ventilator synchrony
Bath Cabinet respirator
Dr. Charles Breuillard of Paris 1887
Iron lung/tank ventilation
Dr. Woillez of Paris (1876)
Dr. Woillez’s iron lung had a unique feature which was a rod which rested lightly on the patient’s chest, to give visual proof of actual lung expansion. Dr. Woillez refused to patent his invention.
In 1887 bath cabinet respirator was invented. It utilized the water steam to generate negative extrathoracic pressure
Chest rise observation
Iron lung
Drinker and Shaw 1929.The Drinker Shaw version of the iron lung was the
first commercially successful tank ventilator
Iron lung
John Haven Emerson of Cambridge 1931
Pioneer of tank and piston ventilators
The youngest polio victim treated in an Iron Lung
In the bottom photo you see how a mirror was used to let the patient see and interact with caregivers
Dragger first mass produced iron lungs in GermanyThey even installed it into a van – a Volkswagen of course
“
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There were also hand held positive pressure devices based on a bellows or pump
One example of a hand held pump is this Cleveland respirator
Here is a bellows based positive pressure ventilator using a head-box – sort of the opposite of a tank ventilator
Hinreich Dräger
•The Draeger company was one of the very first to develop resuscitation equipment because they were a mining company•They have continued to be a leader in innovative ventilator technology to the present time
During the epidemic of poliomyelitis in the 40, and early 50'sEmerson machine gained an extinguished popularity in saving lives of children who suffered the disease. What you see here is not a factory but rather an intensive care unit. 1953 Polio Epidemic
Rocking Bed ventilation, 1950’s
The rocking bed provided artificial respiration in cases of respiratory weakness, but did not provide enough tidal air for the patient with paralysis of the muscles of respiration.Ventilation was facilitated by the passive movement of the diaphragm as a consequence of the movement of the abdominal contents under the effect of gravity.
Pneumomotor chest cuirass with rocking bed
Dianne Odell listen to her mother Geneva Odell at a Christmas Gala in her daughter's honor at the Jackson Fairgrounds Park in Jackson, Tenn. on Dec. 4, 2001. Dianne, has been in an iron lung for 51 years since being paralyzed by polio at age 3. Odell is believed to be the longest-lived polio survivor inside an iron lung. (Bill Poovey. Associated Press Published in the Athens Banner-Herald on Wednesday, February 20, 2002.•Amazingly the machine was able to maintain the life of this patient for 51 years.
Mark O'Brien, poet, journalist and inspirational voice in the movement of disabled people to lead independent lives, died early Sunday morning, July 4,1999, in his home in Berkeley, Calif. Mr. O'Brien was 49 years old. (1949-1999)
Alexander, from Texas, is now almost 68. He was left completely paralyzed by polio at the age of six, owing to which his lungs stopped working; he has been largely dependent on and confined to his iron lung ever since. It has now been 62 years that Alexander has spent in the iron lung: he still remains completely paralyzed, and is only able to move his head, neck, and mouth.
Pulmo-Wrap Ventilator Hayek Oscillator
Jacket ventilators
Doubled as a canister vacuum cleaner
A) Tracheostomy (3000 years ago)
Bristol Myers Co. stated that the Clinton Nebulizer produced a vapor which, when inhaled, reaches all parts of mucosal membrane of the nasal passages and is carried deep into the lungs.
Indications:Chronic Bronchitis, Asthma, Tuberculosis and Pneumonitis.
Contains:Oil, Sandalwood, Eucalyptol, Menthol, Thymol, Camphor and Terebene .
Van Slyke Analyzer
Louis Ombredanne (1871 -1956), a French Pediatric Surgeon, published a paper detailing his new Ether inhaler in 1908. He listed a number of flaws in the Clover inhaler that were surmounted by his design.
Dr. Jackson an ENT Surgeon from Philadelphia, developed a series of Sterling Silver Tracheostomy tubes with Trocas with Caps which were manufactured by the Henry Pilling Company in Philadelphia.These high quality baby to adult tracheostomy tubes established worldwide standards for all tracheostomy tubes
BiographyForest Bird MD,PhD,ScD,FAARC
door knob
• positive pressure• nebulization • both
photo courtesy of Rich Branson
Biography: Forest Bird MD,PhD,ScD,FAARC
Dr. BIRD’S BABY BIRD was introduced on small babies with Respiratory Distress Syndrome at the Willford Hall US Air Force hospital by doctors Kirby, Delemus and Null. Within two years the BABY BIRD reduced overall respiratory deaths in babies from about 60% to below 10%.
Biography: Forest Bird MD,PhD,ScD,FAARC
The first production Mark 7, Serial Number 0001. This device was delivered to Dr. Andre Cournand for use at Bellevue Hospital in New York, 1957
Flow control valve (1947)
In the US, Ray Bennett was the first to pioneer innovative positive pressure ventilators, starting with breathing assist devices for air force pilotsHe is best known for his ingenious flow control valve, which made pressure cycled ventilation practical and led to the first IPPB machines
Bennett TV-2P, Santa Monica , CA 1949
MORCH Respirator, 1954 BIRD MARK 2
DRAGER SPIROMAT, 1955
MA-1 (1967))
PURITAN BENNETT 2500 Transport Volume Ventilator,1969
BENNETT MA-1, 1967
1964 EMERSON, Post-Op RESPIRATOR, 3-PV
Servo 900C (1982)
Puritan Bennitt 7200 (1984)
Bear 1000 (1992))
PB 740
Servo 300 (1991)
PB 840
Maquet Sero U Draeger V500 Hamilton G-5
Who knows
