Biphasic Cuirass Ventilation
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Biphasic Cuirass Ventilation (BCV) is a method of ventilation which works using a non-invasive cuirass or shell, attached to a power unit which actively controls both phases of the respiratory cycle (the inspiratory and expiratory phases). This method has in the past often been described and labeled as 'Negative Pressure Ventilation' (NPV), 'External Chest Wall Oscillation' (ECWO), 'External Chest Wall Compression' (ECWC) and 'External High Frequency Oscillation' (EHFO). However the term that most accurately and most correctly describes the method of ventilation used by Dr Hayek's RTX series of respirators and also by Dr Hayek's previous respirator, the Hayek Oscillator (H.O), is Biphasic Cuirass Ventilation (BCV).
As ventilation is Biphasic, it is possible to achieve both higher tidal volumes (negative inspiratory tidal volume and positive expiratory tidal volume), higher frequencies -from 6 to 1200CPM, and also for the user to have proper and real control over I:E Ratio, without having to depend on passive recoil of the patient. In addition, the patented technology used for the cuirass and its disposable seal in the RTX allows for a comfortable fit and seal of the air within the cuirass. These advantages allow for a much higher minute ventilation to be created and thus making complete ventilation possible in both normal and sick lungs.
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[edit] BCV and Ideal Ventilation
Biphasic Cuirass Ventilation (BCV) is often an ideal method of ventilation as it:
1. Provides complete ventilation to patient
2. Is non-invasive and avoids many of the dangers and problems associated with invasive ventilation such as infection and barotraumas.
3. Works in a physiological way, in that it:
- 1. Works in the way that the lungs work most efficiently by actively controlling both phases of the respiratory cycle
- 2. Provides even ventilation for patient
- 3. Helps to maintain and redevelop the respiratory muscles which often wither and waste with respiratory failure and mechanical ventilation
- 4. Improves cardiac output
4. Provides an efficient method of weaning from PPV
5. Assists patient to remove secretions which are a symptom of most respiratory diseases, aggravating the condition of these patients
6. Can begin to provide treatment for patients before their condition deteriorates and hospitalisation is required
7. Allows for continuity of treatment for patients in hospital, at home, in transport and in emergency situations
8. Is simple to use.
[edit] Patient Groups
BCV has been successfully used on patients with: Acute Respiratory Failure Chronic Obstructive Pulmonary Disease (COPD) Neuromuscular (e.g. SMA, Duchennes etc) Head and Spinal Injuries Problems with Weaning from PPV Ventilation during anaesthesia in Ear Nose and Throat (ENT) Procedures Cystic Fibrosis (CF), and those who require physiotherapy Aids Related Lung Disease Asthma Ventilation post-operation Eg. post-coronary bypass, Fontan, Fallot, post-pneumonectomy
[edit] BCV Quotes
COPD: "can be effectively used in severe COPD and respiratory failure for (1) assisting ventilation, thus replacing intubation and conventional mechanical ventilation and (2) relieving muscle fatigue"
CHEST "Acceptable and effective alternative mode of non-invasive ventilatory support in COPD patients" American Journal of Respiratory and Critical Care Medicine
Weaning from PPV: "Was used on patients who were..difficult to wean. Reventilation could be achieved within seconds, without the need for reintubation and without hazard to the patient. Therefore..arrest of ventilation was easily decided on" "Avoids the need for endotracheal intubation, thus reducing the hazards of mechanical ventilation attributable to intubation." Respiration and Circulation
Secretion Clearance: "it is remarkable that the patient expelled sputum whenever he was connected..far beyond that achievable by physiotherapy" Respiration and Circulation
"A further advantage was a spontaneous mucus expulsion, each time. American Recent advances in Anaesthesia, Pain, Intensive Care and Emergency has been shown to be equal or superior to CPT (Chest Physiotherapy) in mobilizing secretions. This study suggests that, in contrast to CPT, it is well tolerated and effective in SHI (Severe Head Injury), even with intracranial hypertension" American Association of Neurological Surgeons
During and Post-Surgery: "has overcome the major problem of safely oxygenating patients undergoing laser surgery to the upper aerodigestive tract while leaving the surgical field unencumbered..We recommend that it is used to ventilate patients in all cases of laser surgery to the upper digestive tract, to overcome potential risks"
"Lasers in Medical Science was used on 41 patients undergoing surgery to the larynx without the use of tracheal tube. Gas exchange and cardiovascular parameters remained satisfactory during the use of this technique, which offers a significant advance over existing tubeless methods of anesthesia" Anesthesia
Cardiac Output: "Increases cardiac index and improves tissue perfusion...distinct cardiovascular benefits as ventilatory assistance" European Journal of Cardio-thoracic Surgery
"An improvement in cardiac output of this order, and by this mechanism, is currently unmatched by any therapeutic alternatives" Circulation
Other Quotes: "this was successful with X-ray as well as clinical improvement and a reduction in ICU stay." Clinical Intensive Care "accomplished in a manner that was non-invasive, safe and comfortable" American Review of Respiratory Disease "The technique is noninvasive, well tolerated and costs less." Recent Advances in Anesthesia, Pain, Intensive Care and Emergency
