Conclusions

External negative pressure ventilation, as supplied by the Hayek oscillator, appears to be a useful addition to conventional ventilatory techniques in the management of both adult and pediatric intensive care patients. This may be particularly true in patients with a compromised cardiac output or in protracted weaning cases.

Early evidence regarding the use of combination ventilation in ARDS appears to be extremely promising, although further investigation is required before judgment can be passed on its true place in the acute management of such cases. In this context, it would seem sensible to limit the technique to patients with acute lung trauma and to attempt to institute a rapid response environment, allowing the ventilator to be transported to the patient as soon as the appropriate entry criteria have been satisfied.

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