Gracey, Douglas R

Three patients with different neurologic diseases—amyotrophic lateral sclerosis, poliomyelitis, and idiopathic bilateral diaphragm paralysis—and with chronic ventilatory failure were successfully ventilated with negative pressure. This noninvasive ventilatory technique uses a chest cuirass and provides an alternative to tracheostomy and positive-pressure ventilation. As a result of the benefits that these three patients received, we conclude that the cuirass remains an acceptable method of ventilation for some patients with chronic neurologic disease.