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December 8, 1975

Mechanical Ventilation Techniques-Reply

Author Affiliations

University of Colorado Medical Center Denver

JAMA. 1975;234(10):1018. doi:10.1001/jama.1975.03260230018009

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In Reply.—  Early in my career, I had considerable experience with the breathing methods listed. The over-whelming inadequacies of these techniques, in fact, became a major stimulus that encouraged me to look for more definitive methods of intensive respiratory care and assist in the design of new respirators. Whereas the tank respirator was useful in managing patients with paralytic disorders, particularly poliomyelitis, nursing care was difficult, to say the least. The fixed one-to-one inspiratory expiratory ratio, the difficulties in maintaining a seal around the neck, and the limited pressure capability made effective respiratory support difficult or even impossible for many people, particularly those with obesity. With no ability to vary inspiratory expiratory ratios, modify pressure wave forms, or control flow rate and with no capability of assisted ventilation, this method of ventilatory support is rendered particularly inappropriate in chronic obstructive lung diseases.The chest-abdomen cuirass was and is a method