Why couldn’t polio patients dependent on mechanical ventilation be transferred from iron lungs to less invasive positive pressure ventilators once they were invented?

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I hope this is an okay post. It doesn’t directly concern any recent events per se, though a recent event did lead me to think of this question

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They can be, and a lot were. However, iron lungs use negative pressure ventilation (where they increase their volume, which decreases the pressure inside and kinda sucks the chest up so you can take a normal breath), whereas most modern treatments use positive pressure ventilation (where air is pushed into your mouth by a pump, normally).

Negative pressure ventilation is more close to our natural breathing, so some people preferred it. In a way, positive pressure ventilation is more invasive!

Although iron lungs are unwieldy, many patients using them because of polio would be paralysed from the neck down anyway (like the recently deceased Paul Alexander), so it may not have impact their mobility. There are also some other medical conditions that might not allow for positive pressure ventilation.

Patients using iron lungs don’t have to spend all of their time in them – June Middleton, who was in one for six decades, would use it for 21 hours a day to assist her breathing. Paul Alexander was taught how to breathe using his neck muscles, meaning he could also leave for short periods.

Also, you have to consider the psychological attachments that people may form to these devices which breathe for them, and which they rely on to survive. It might be too scary for patients to try something else, particularly if the iron lung has worked so far.

Recent cases of people still in iron lungs are popular in the news because of their novelty, giving a popularity bias that makes them seem perhaps more common than they are

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