Transcript Dr Philip Drinker

Historical Perspective
Dr Tom Hilliard
Consultant in Paediatric
Respiratory & Sleep Medicine
Dr Philip Drinker
Developed ‘iron lung’ ventilator, 1928
1948 US polio epidemic
Bower and colleagues (Los Angeles) reported success
with IPPV applied to the airway. They had two Bennett
positive pressure valves which they used to supplement
tank respirators:
 to supply helium-oxygen mixtures during inspiration.
 to provide respiration when the tank respirator was opened
for nursing procedures.
 to provide adequate ventilation in emergencies or transfer.
 to inflate or re-expand lung that was collapsed or.was
congested by pulmonary oedema.
1952 Copenhagen polio epidemic
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Begdam Hospital, Aug-Dec 1952
3000 cases admitted
2241 confirmed poliomyelitis
1250 had paralysis
345 needed treatment for respiratory
insufficiency
Dr. Bjørn Ibsen, 1952
• tracheotomy just below the
larynx
• inflatable rubber cuff tube in
trachea
• frequent suction
• repeated bronchoscopy
• postural drainage
• manual positive pressure
ventilation using oxygen and
nitrogen.
Re-emergence of non-invasive
ventilation
1947 Motley et al. Am J Med ….use of IPPB
via mouthpiece for acute care…….
1960s Goldwater Rehabilitation Center, NY
….nocturnal and daytime IPPB for NM
disease…….
1981 Sullivan …introduction of face mask for
treatment of OSA……
1983 Rideau …..application in DMD………
Survival in hypercapnic patients
with DMD
Health-related QoL
Survival by cohort
LTV children in the UK 1999
• Questionnaire survey
• Children 0-16 years
• 141 children identified
80
70
60
50
New patients
40
Current patients
30
20
10
0
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Long-term ventilation case load 1996 – 2008
2008