2025
A pilot study on the hemodynamic effects of negative pressure ventilation in patients after cardiac surgery focusing on right ventricular function
https://doi.org/10.1038/s41598-025-12534-1
Simon, S., Helena, G., Laura, S., Klaas, F., David, H., Matthias, H., Lennart, M. (2025). Scientific Reports, 15, 27974.
Negative pressure ventilation increased cardiac index across patients, with improved oxygen balance primarily observed in patients with impaired cardiac performance and elevated LVEDP.
Breathing against the odds: the return of negative pressure ventilation
https://doi.org/10.1093/sleepadvances/zpaf053.154
Aiyappan, V., Bassett, K., Bandick, L. (2025). Sleep Advances: A Journal of the Sleep Research Society, 6(Suppl 1), A54.
A 39-year-old patient with motor neuron disease transitioned from positive pressure NIV to biphasic cuirass BCV, tolerated the BCV well, and was weaned off NIV with intermittent daytime BCV use.
Oxygenation techniques in head and neck surgery
https://doi.org/10.1097/ACO.0000000000001577
McNarry, A. F., Ward, P. A., Paternò, D. S., Sorbello, M. (2025). Current Opinion in Anaesthesiology, 38(6), 834-840.
Adequate oxygenation strategies during head and neck surgery must balance patient pathology with surgical access, with high-flow nasal oxygenation and jet ventilation offering extended apneic oxygenation and improved surgical exposure when applied with team coordination.
The Stiff Lung Cries Out for Negative Pressure Ventilation
https://doi.org/10.46889/JCMR.2025.6307
Van Egmond, J. (2025). Jour Clin Med Res, 6(3), 1-3.
Negative pressure ventilation restores pleural pressure to physiological baseline, preventing airway closure and stress, while positive pressure ventilation elevates pleural pressure, compresses lung tissue, and promotes atelectasis.
Novel use of negative pressure ventilation for weaning of venovenous extracorporeal membrane oxygenation
https://doi.org/10.1177/02676591251388793
Green, A., Ashokkumar, S., Wadud, N., Feng, B., Puri, N., Bartock, J. (2025). Perfusion, 02676591251388793.
Combined positive and negative pressure ventilation promoted more homogeneous lung inflation, improved ventilatory distribution, reduced alveolar overdistention, and supported diaphragmatic movement during VV ECMO weaning.
2024
Negative Pressure Ventilation Can Prevent Ventilator-associated Brain Injury
https://doi.org/10.1164/rccm.202402-0300ED
van Rijn, C. M., Roberts, J. H., Coulthard, M. G., Lambert, H. J., McKeown, D. S., Howard, D. J., van Egmond, J. (2024). American Journal of Respiratory and Critical Care Medicine, 210(7), 954–955.
Negative pressure ventilation may reduce ventilator-associated brain injury and represent a brain-protective strategy that supports long-term neurological outcomes and quality of life in mechanically ventilated patients.
Negative Pressure Ventilation Can Prevent Ventilator-associated Brain Injury
https://doi.org/10.1164/rccm.202402-0300ED
van Rijn, C. M., Roberts, J. H., Coulthard, M. G., Lambert, H. J., McKeown, D. S., Howard, D. J., van Egmond, J. (2024). American Journal of Respiratory and Critical Care Medicine, 210(7), 954–955.
Negative pressure ventilation may reduce ventilator-associated brain injury and support neurologic outcomes and quality of life in mechanically ventilated patients.
Negative Pressure Ventilation in the Pediatric ICU
https://rc.rcjournal.com/content/69/3/354.short
DeRusso, M., Miller, A., Caccamise, M., Alibrahim, O. (2024). Respiratory Care, 69(3), 354–365.
This review outlines the physiological principles of spontaneous breathing and negative pressure ventilation, evaluates supporting clinical evidence, provides practical guidance for pediatric ICU use, and highlights areas for future research.
Biphasic Cuirass Ventilation for Airway Surgeries: A Comprehensive Review
https://doi.org/10.7759/cureus.75477
Bodhey, A., Bodhey, M., Shallik, N. A., Al Nadhari, M., Griess, H. F., Al Ani, O., Thomas, K. (2024). Cureus, 16(12), e75477.
This review evaluates the feasibility and perioperative use of biphasic cuirass ventilation in airway surgeries and summarizes existing clinical literature supporting its application.
2023
Negative Pressure Is the Positive Way to Breathe
https://doi.org/10.1164/rccm.202210-1862ED
Katira, B., Cereda, M. (2023). American Journal of Respiratory and Critical Care Medicine, 207(5).
Negative pressure ventilation favors more homogeneous alveolar expansion and improved recruitment in collapsed lung regions, while positive pressure ventilation may promote inhomogeneous inflation and stress concentration.
Biphasic cuirass ventilation in the escalation of non-invasive ventilation in COVID-19: Case report and review
https://doi.org/10.4081/monaldi.2023.2510
Borges, J. A., Esquinas, A. M. (2023). Monaldi Archives for Chest Disease.
Combined use of high-flow nasal oxygen and biphasic cuirass ventilation supported de-escalation of respiratory support and avoided endotracheal intubation in a critically ill COVID-19 patient.
Pulmonary Complications in Patients With Fontan Circulation
https://doi.org/10.1016/j.jacc.2023.04.036
Abdulkarim, A., et al. (2023). Journal of the American College of Cardiology, 81(25), 2434–2444.
Positive airway pressure must be used cautiously after Fontan circulation due to potential reduction in pulmonary blood flow and cardiac output, while inspiratory muscle training improved exercise tolerance, respiratory strength, and resting cardiac output.
2022
Positive- and Negative-Pressure Ventilation Characterized by Local and Global Pulmonary Mechanics
https://doi.org/10.1164/rccm.202111-2480OC
Sattari, S., Mariano, C. A., Kuschner, W. G., Taheri, H., Bates, J. H. T., Eskandari, M. (2022). American Journal of Respiratory and Critical Care Medicine.
Negative pressure ventilation demonstrated earlier lung recruitment, higher pressure volume compliance, reduced hysteresis and energy loss, and lower local tissue strain compared with positive pressure ventilation.
Assessment of lung recruitment with continuous negative extrathoracic pressure after one-lung ventilation: an experimental investigation
https://erj.ersjournals.com/content/60/suppl_66/1663.abstract
Schranc, Á., Diaper, J., Südy, R., Peták, F., Habre, W., Albu, G. (2022). European Respiratory Society International Congress Abstract.
Application of continuous negative extrathoracic pressure efficiently recruited atelectatic lung without inducing pulmonary edema, and combined use with positive pressure ventilation reduced atelectasis following lung collapse during thoracic procedures.
Negative-Pressure Ventilation in Neuromuscular Diseases in the Acute Setting
https://doi.org/10.3390/jcm11092589
Annunziata, A., Calabrese, C., Simioli, F., Coppola, A., Flora, M., Marotta, A., Di Spirito, V., Didonna, F., Cicalese, M., Fiorentino, G. (2022). Journal of Clinical Medicine, 11(9).
Negative pressure ventilation offers a viable option for patients with neuromuscular diseases and acute or chronic respiratory failure, with modern devices improving comfort and supporting personalized respiratory management based on disease complexity.
2021
Non-Invasive Respiratory Assessment in Duchenne Muscular Dystrophy: From Clinical Research to Outcome Measures
https://doi.org/10.3390/life11090947
Pennati, F., LoMauro, A., D’Angelo, M. G., Aliverti, A. (2021). Life, 11, 947.
This review outlines respiratory outcome measures in Duchenne muscular dystrophy, showing lung volume recruitment improves respiratory compliance and slows FVC decline, while combined inspiratory support and assisted cough improves peak cough flow and reduces respiratory complications.
Use of Negative Pressure Ventilation in Pediatric Critical Care: Experience in 56 PICUs in the Virtual Pediatric Systems Database (2009–2019)
https://doi.org/10.1097/PCC.0000000000002681
Moffitt, C. A., Deakins, K., Cheifetz, I., Clayton, J. A., Slain, K. N., Shein, S. L. (2021). Pediatric Critical Care Medicine, 22(6), e363–e368.
Negative pressure ventilation was used across multiple PICUs, most often for pulmonary infection or cardiac disease, frequently alongside other support modalities, with increasing adoption suggesting the need for prospective studies to define safety and identify patients most likely to benefit.
Novel Use of Biphasic Cuirass Ventilation During Definitive Radiation Therapy: A Technical Report
https://doi.org/10.1016/j.prro.2020.08.006
Clinkscales, W., Spence, M., Gleysteen, J., Hayes, N., Izaguirre, E., Wakefield, D., Schwartz, D., Rhea, I., Risquez, C., Sharma, A. M. (2021). Practical Radiation Oncology, 11(3), e276–e281.
Biphasic cuirass ventilation enabled radiation therapy delivery in patients unable to tolerate positioning, offering a noninvasive alternative to tracheostomy.
Successful Application of Long-Term Negative Pressure Ventilation in a Pediatric Patient with Congenital Muscular Dystrophy
https://doi.org/10.1164/ajrccm-conference.2021.203.1_MeetingAbstracts.A3440
Kim, S., Velasco, J. (2021). American Thoracic Society International Conference Abstract.
Long-term negative pressure ventilation supported chronic respiratory failure management in a pediatric neuromuscular patient when invasive ventilation was not desired.
Predictive factors of continuous negative extrathoracic pressure management failure in children with moderate to severe respiratory syncytial virus infection
https://doi.org/10.1038/s41598-021-87567-1
Ishimori, S., Okizuka, Y., Onishi, S., Shinomoto, T., Minami, H. (2021). Scientific Reports, 11, 8063.
Continuous negative extrathoracic pressure was effective in selected pediatric RSV patients, with age and specific clinical markers predicting treatment success.
The role of a negative pressure ventilator coupled with oxygen helmet against COVID-19: a review
https://doi.org/10.1007/s42600-021-00149-0
Chandrasekaran, K., Shaji, A. M. (2022). Research on Biomedical Engineering, 38, 267–278.
Negative pressure ventilation combined with oxygen helmet support showed fewer limitations than traditional approaches and potential benefit in COVID-19 related ARDS.
A pilot study of short-term hemodynamic effects of negative pressure ventilation in chronic obstructive pulmonary disease assessed using electrical cardiometry
https://doi.org/10.1111/anec.12843
Chao, K. Y., Nassef, Y. (2021). Annals of Noninvasive Electrocardiology, 26(5), e12843.
Negative pressure ventilation altered hemodynamics in COPD patients, with reduced thoracic fluid content and measurable effects captured by electrical cardiometry.
Preliminary Experience with Continuous Negative Pressure Ventilation (CNEP) in Covid-19 patients requiring respiratory support
Diaper, J., Bendjalid, K., Neto Da Venda E Silva, I. (2021). Swiss Medical Weekly, 151(Suppl 254), 7S.
Continuous negative pressure ventilation guided by electrical impedance tomography showed promising early results in COVID-19 respiratory failure.
A new mode of mechanical ventilation: positive plus negative synchronized ventilation
https://doi.org/10.4081/mrm.2021.788
Vincenzi, U. (2021). Multidisciplinary Respiratory Medicine, 16.
Synchronized positive and negative pressure ventilation offered a novel approach to improve ventilation mechanics and patient synchrony.
2020
Industry Insider: Airway Clearance Therapy Solutions
RT Magazine. October 2020.
Biphasic cuirass ventilation was highlighted as an innovative airway clearance therapy option with potential to improve ACT programs and clinician experience.
Negative pressure ventilation as a bridge to lung transplant
https://doi.org/10.1093/omcr/omaa056
Martínez, M. D. P., Alvarez, F. G., Mallea, J. M., Shah, S. Z., Pham, S. M., El-Sayed Ahmed, M. M., Jacob, S., Janik, A. B., Haddad, T., Erasmus, D. B., Narula, T. (2020). Oxford Medical Case Reports, 2020(8).
Negative pressure ventilation enabled active rehabilitation, oral intake, and communication while serving as a feasible bridge strategy for selected patients awaiting lung transplant.
Augmentation of pulmonary blood flow and cardiac output by non-invasive external ventilation late after Fontan palliation
https://doi.org/10.1136/heartjnl-2020-317163
Charla, P., Karur, G. R., Yamamura, K., Yoo, S. J., Granton, J. T., Oechslin, E. N., Shah, A., Benson, L. N., Honjo, O., Mertens, L., Hanneman, K., Alonso-Gonzalez, R., Wald, R. M. (2020). Heart, 107(2), 142–148.
External thoraco-abdominal ventilation increased pulmonary blood flow and cardiac output after Fontan palliation, with biphasic modes producing greater hemodynamic augmentation than negative pressure alone.
Description of 3 patients with myasthenia gravis and COVID-19
https://doi.org/10.1177/1084822320977036
Reina, N., Hahama, N., Orenbuch-Harroch, E., Romain, M., Argov, Z., Vaknin-Dembinsky, A., Gotkine, M. (2020). Home Health Care Management & Practice, 32(1), 40–44.
Intermittent and continuous biphasic cuirass ventilation combined with high-flow nasal cannula supported respiratory recovery and avoided invasive ventilation in a patient with myasthenia gravis and COVID-19.
Evolving Therapies in Fontan Failure
Roche, L., Wald, R. (2020). American College of Cardiology.
External ventilation increased pulmonary blood flow and cardiac output in Fontan failure, with biphasic settings demonstrating better tolerance and greater physiologic response.
Biphasic Cuirass Ventilation in a Patient with Congenital Myotonic Dystrophy
https://doi.org/10.1164/ajrccm-conference.2020.201.1_MeetingAbstracts.A1928
Almeda, M., Puranik, S., Felker, M., Daftary, A. S. (2020). American Thoracic Society International Conference Abstract.
Polysomnography-titrated biphasic cuirass ventilation successfully treated hypoventilation, feeding difficulty, and failure to thrive without inducing obstructive sleep apnea.
Predictors of Negative Pressure Ventilation Response in Pediatric Acute Respiratory Failure
https://rc.rcjournal.com/content/65/1/91
Nunez, C. A., Hassinger, A. B. (2020). Respiratory Care, 65(1), 91–98.
Negative pressure ventilation successfully supported most pediatric patients with acute respiratory failure, with early reduction in oxygen requirement predicting positive response.
Concurrent Use of Biphasic Cuirass Ventilation and Low-intensity Noninvasive Positive Pressure Ventilation
https://journals.lww.com/clinpulm/Abstract/2020/01000/Concurrent_Use_of_Biphasic_Cuirass.6.aspx
Tada, M., Kadowaki, T., Tsubouchi, Y., et al. (2020). Clinical Pulmonary Medicine, 27(1), 26–29.
Concurrent biphasic cuirass ventilation and low-intensity NPPV improved tidal volume and reduced PaCO₂ without increasing airway pressure in patients with pneumothorax and insufficient NPPV response.
2019
Feeling the Pressure: Recurrent Pneumothorax due to Non-Invasive Pressure Ventilation in a Centenarian
https://academic.oup.com/sleep/article/42/Supplement_1/A423/5451797
Hsu, N., Maller, A., Chang, M., Ziedler, M. (2019). SLEEP, 42(Suppl 1).
Positive pressure ventilation was associated with recurrent pneumothoraces, while transition to cuirass negative pressure ventilation supported chronic hypercapnic respiratory failure.
Biphasic Cuirass Ventilation in an Infant with Respiratory Insufficiency Caused by Acute Flaccid Myelitis
Dunydam, A. (2019). Poster presentation.
Biphasic cuirass ventilation supported respiratory recovery and function as a potential weaning strategy in neuromuscular disease after prolonged mechanical ventilation.
Cuirass Ventilation: An Alternative Home-Based Modality for Chronic Respiratory Failure
https://doi.org/10.1177/1084822319875111
Baumrucker, S., Onweni, C., Rashid, M., Goswami, R., Treece, J., Shipley, L., De Souza, R., O’Neill, B., Simberloff, J. (2019). Home Health Care Management & Practice.
Cuirass ventilation supported long-term home respiratory care, reduced complications associated with positive pressure ventilation, and improved quality of life in patients with chronic respiratory failure.
Ventilation in Patients with Intra-Abdominal Hypertension: What Every Critical Care Physician Needs to Know
https://doi.org/10.1186/s13613-019-0522-y
Regli, A., Pelosi, P., Malbrain, M. L. N. G. (2019). Annals of Intensive Care, 9, 52.
Intra-abdominal hypertension significantly impacts respiratory mechanics and outcomes, underscoring the importance of individualized ventilatory strategies in critically ill patients.
Removal of Lung Lavage Fluid during Whole Lung Lavage Using Biphasic Cuirass Ventilation Chest Percussion in Autoimmune Pulmonary Alveolar Proteinosis
https://doi.org/10.4103/lungindia.lungindia_193_19
Nakamura, K., Omura, S., Kajiura, K., Ishigaki, M. (2019). Lung India, 36(6), 540–542.
Biphasic cuirass ventilation provided effective chest percussion during whole lung lavage and facilitated mucus clearance without invasive ventilation.
Continuous External Negative Pressure Improves Oxygenation and Respiratory Mechanics in Experimental Lung Injury in Pigs
https://doi.org/10.1186/s40635-020-00349-5
Scharffenberg, M., Wittenstein, J., Herzog, M., Tauer, S., Vivona, L., Theilen, R., Bluth, T., Kiss, T., Koch, T., Fiorentino, G., Gama de Abreu, M., Huhle, R. (2020). Intensive Care Medicine Experimental, 8(Suppl 1), 49.
Continuous external negative pressure shifted ventilation toward dependent lung regions and improved oxygenation and respiratory mechanics in experimental lung injury.
Acute Hemodynamic Effects of Negative Extrathoracic Pressure in Fontan Physiology
https://doi.org/10.1007/s00246-019-02197-x
Peng, D. M., Zampi, J. D., Smith, S. M., Yu, S., Rottach, N., Lowery, R., Lim, H. M., Riegger, L. Q., Schumacher, K. R., Rocchini, A. (2019). Pediatric Cardiology, 40, 1633–1637.
Negative extrathoracic pressure reduced pulmonary vascular resistance and improved hemodynamics in ambulatory Fontan patients with heart failure.
BCV for Tiny Lungs
Mefford, G. (2019). Neonatal Intensive Care, 32(3).
Biphasic cuirass ventilation was evaluated against invasive positive pressure ventilation for gas exchange, pulmonary mechanics, and hemodynamic stability in neonates.
Management of Persistent Air Leak Using Negative Pressure Ventilation in the Pediatric Intensive Care Unit
https://doi.org/10.1164/ajrccm-conference.2019.199.1_MeetingAbstracts.A4976
Patel, M., Guglani, L., DeAlmeida, M., Simon, D. (2019). American Thoracic Society International Conference Abstract.
Negative pressure ventilation successfully managed persistent air leak in a pediatric patient when positive pressure ventilation and surgical options were contraindicated.
Maintenance Negative Pressure Ventilation Improves Survival in COPD Patients with Exercise Desaturation
https://doi.org/10.3390/jcm8040562
Huang, H. Y., Lo, C. Y., Yang, L. Y., Chung, F. T., Sheng, T. F., Lin, H. C., Lin, C. W., Huang, Y. C., Chang, C. J., Chung, K. F., Wang, C. H. (2019). Journal of Clinical Medicine, 8(4), 562.
Maintenance negative pressure ventilation improved survival and respiratory outcomes in COPD patients with exercise-induced desaturation.