http://publicationslist.org/data/exovent/atom.xmlExo Vent's Publications ListExo Venthttp://publicationslist.org/exovent$basepathfavicon.icoRecent additions to Exo Vent's PublicationsList.org pagehttp://publicationslist.org/publications.png2026-04-20T19:57:22Zhttp://publicationslist.org/exovent/refid222026-04-20T19:56:15ZWhy Do We Ignore Negative Pressure Ventilation in COPD?
To the Editor:
We read with interest the recent CHEST Critical Care review1 that addressed noninvasive ventilation in severe COPD exacerbation. Although their emphasis on noninvasive ventilation and limiting plateau pressures is important, we believe that reconsidering negative pressure ventilation (NPV) o'ers physiologic advantages that are not provided by current positive pressure modalities.2,...<br/><br/>van Egmond J, Mulier J P (2026) <i>Chest Crit Care</i> : <br/>http://publicationslist.org/exovent/refid122026-04-07T12:08:32ZAtelectasis: The Price of Positive Intra-Thoracic Pressure.Editorial
During the 1952 Copenhagen polio epidemic, Bjørn Ibsen’s use of Positive Pressure Ventilation (PPV) via tracheostomy solved his shortage of negative-pressure ventilators. The simplicity of applying an endotracheal tube-with full access to the thorax and abdomen-proved advantageous during surgery and intensive care. Ibsen’s dramatic success rapidly transformed respiratory care world...<br/><br/>van Egmond J, Mulier JP. (2026) <i>Journal of Clinical Medical Research</i> 7: 1 1-3<br/>http://publicationslist.org/exovent/refid102026-04-07T12:08:14ZRethinking Mechanical Ventilation: Can Ventilation Mode Influence Long-Term Cognitive Outcomes in ICU Patients with COVID-19?Long-term cognitive impairment is common among ICU patients who required invasive mechanical ventilation (IMV). Its etiology is likely multifactorial. This preregistered study examined the association between the duration of IMV and cognitive function post-ICU, as well as the moderating effects of age and cognitive reserve. A secondary analysis was conducted using data from a published study of C...<br/><br/>van Rijn CM, Godoy-González M, Fernández-Gonzalo S, Souren P, Coulthard MG, Howard DJ, Jongsma MLA. (2026) <i>Journal of clinical medicine</i> <i></i> <i></i> 15: 2 <br/>http://publicationslist.org/exovent/refid202026-04-20T07:48:48ZDelayed Detection of Iatrogenic Pneumothorax Under Positive-Pressure Ventilation: A Case Report.Subclavian venous access may result in pleural injury. During positive-pressure ventilation (PPV), increased intrathoracic pressure compresses peripheral lung tissue, promoting closure of terminal airways. As a result, air leakage from injured lung regions may remain confined and not communicate with the pleural space, rendering intraprocedural and early post-procedure imaging falsely negative. We...<br/><br/>Jan P Mulier, Louise Beckers Perletti, Jan van Egmond (2026) <i>A&A practice</i> <i></i> <i></i> 20: 4 <br/>http://publicationslist.org/exovent/refid212026-04-20T19:54:40ZFundamental Misconceptions in the Interpretation of the Origin of
Ventilator-Induced Lung InjuryLetter to Editor
Conceptual errors underlie much of today’s interpretation of mechanical ventilation and
the rationale of Lung-Protective Strategies (LPS). In LPS Tidal Volume (TV) must be minimized, even when ventilation remains far below vital capacity. This view treats “stretch” as intrinsically injurious. Yet the mechanical consequences of any given volume change depend critically on t...<br/><br/>van Egmond J., Mulier J.P. (2026) <i>Jour Clin Med Res. </i> 7: 1 1-3<br/>http://publicationslist.org/exovent/refid142026-04-07T11:59:13ZPositive Pressure Ventilation for Respiratory Disease – a flawed, non-physiological solution. Further evidence from COVID-19. “Modern” larger mammals developed over the last 65 million years, after the demise of the dinosaurs. All mammals, including hominids, breathe by negative pressure.
Between 1928 and the 1950’s negative-pressure ventilation using so-called “iron lungs” saved countless poliomyelitis epidemic patients, but during the 1950s, when these devices were in short supply, they were largely repl...<br/><br/>Howard DJ, Couldhard MG. (2025) <i>Medical Research Archives</i> 13: 4 1-10<br/>http://publicationslist.org/exovent/refid132026-04-07T12:06:12ZThe Stiff Lung Cries Out for Negative Pressure Ventilation.Introduction
Before the worldwide adoption of positive pressure ventilation (following the polio pandemic, Copenhagen, 1952), patients with atelectasis were curatively treated in the iron lung. After the transition to positive pressure, however, atelectasis became the main complication [1]. An early animal study drawing attention to this problem was countered with the argument that there can be n...<br/><br/>van Egmond J. (2025) <i>Journal Clin Med Res.</i> 6: 3 1-3<br/>http://publicationslist.org/exovent/refid22026-04-07T12:03:43ZIs mechanical power truly the culprit in VILI? Rethinking causality in light of airway closure.van Egmond J, Speight C, Mulier JP. (2025) <i>Intensive care medicine</i> <i></i> <i></i> 51: 10 1964-1965<br/>http://publicationslist.org/exovent/refid12026-04-07T12:11:24ZThe emergence of the "baby lung": a mechanical consequence of positive pressure ventilation and reduced pulmonary compliance.Introduction
Acute respiratory distress syndrome (ARDS) is defined by diffuse alveolar damage, pulmonary edema, and severely reduced lung compliance. Positive pressure ventilation (PPV) is often essential for survival, yet it concentrates mechanical stress on the limited portion of aerated parenchyma—the “baby lung” (1). This conventional concept, however, underestimates the role of chest w...<br/><br/>van Egmond J, Kristensen MS, Mulier JP. (2025) <i>Journal of thoracic disease</i> <i></i> <i></i> 17: 12 11520-11523<br/>http://publicationslist.org/exovent/refid32026-04-07T12:09:01ZThe role of pleural pressure on fluid dynamics and responsiveness.With interest, we read the Editorial of Monnet [1] et al. Recent discussions surrounding fluid management in acute respiratory distress syndrome (ARDS) patients have underscored the critical importance of understand- ing the interplay between mechanical ventilation and fluid dynamics within the thorax. We wish to highlight what appears to be a profound yet underappreciated con- sequence of positiv...<br/><br/>van Egmond J, Booij L, Mulier J. (2025) <i>Intensive care medicine</i> <i></i> <i></i> 51: 3 658-659<br/>http://publicationslist.org/exovent/refid62026-04-07T12:16:16ZAirway closure during mechanical ventilation of acute respiratory distress syndrome patients.With interest we read the article “Phenotypes of esophageal pressure response to the change of positive end-expiratory pressure in patients with moderate acute respiratory distress syndrome” by Cheng et al. (1). The peripheral airway closure might be the underlying mechanism explaining the two types of esophageal pressure (Pes) response phenotypes.
Cheng’s findings underscore once again the...<br/><br/>van Egmond J, Mulier J. (2024) <i>Journal of thoracic disease</i> <i></i> <i></i> 16: 6 4079-4080<br/>http://publicationslist.org/exovent/refid72026-04-07T12:16:40ZThe role of pleural pressure and airway closure during mechanical ventilation.In their recent article, Piquilloud et al. [1] explain the value of knowing pleural pressure (Ppl) for the individual calculation of compliance/elastance of thorax wall and lungs. In the interpretation of Ppl values some important issues must be included: Ppl in the healthy subject is sub- atmospheric, and secondly it shows a gradient of about 7 cmH2O to 8 cmH2O in the pressure going up from non- ...<br/><br/>van Egmond J, Mulier J. (2024) <i>Intensive care medicine</i> <i></i> <i></i> 50: 7 1198-1199<br/>http://publicationslist.org/exovent/refid42026-04-07T12:20:11ZThe role of pleural pressure in inducing pneumothorax and other adverse effects of positive pressure ventilation.Mechanical ventilation, essential for critically ill patients, contrasts with natural respiration, primarily due to differences in pleural pressure ( ). Natural inspiration decreases , pulling the lungs away from the thoracic wall, whereas positive pressure inspiration increases , pushing the lungs against the thoracic wall. This shift has several consequences. First, elevated during positive p...<br/><br/>van Egmond J, Booij LHDJ (2024) <i>Journal of thoracic disease</i> <i></i> <i></i> 16: 11 8103-8109<br/>http://publicationslist.org/exovent/refid52026-04-07T12:19:25ZNegative Pressure Ventilation Can Prevent Ventilator-associated Brain Injury.To the Editor:
With interest we have read the papers of Bassi and colleagues, converging in their viewpoint “Ventilator-associated Brain Injury: A New Priority for Research in Mechanical Ventilation,” in which they emphasize that ventilator-associated brain injury (VABI) needs urgent attention (1). Therefore, we would like to draw attention to a neglected mechanical ventilation method that wi...<br/><br/>van Rijn CM, Roberts JHM, Coulthard MG, Lambert HJ, McKeown DS, Howard DJ, van Egmond J. (2024) <i>American journal of respiratory and critical care medicine</i> <i></i> <i></i> 210: 7 954-955<br/>http://publicationslist.org/exovent/refid82026-04-07T12:19:04ZNegative pressure ventilation, an umbrella against ventilator induced lung injury.In their clear overview on ventilator-induced lung injury (VILI) in Intensive Care Medicine, Gattinoni and colleagues [1] call to mind that mechanical ventilation (MV) should provide sufficient gas exchange without generating additional injury. However, current MV does cause VILI [1]. We would like to draw attention again to a neglected MV method: negative pressure ventilation (NPV). NPV is not on...<br/><br/>Roberts JHM, Vanhoutte J, Howard DJ, van Rijn CM, van Egmond J; Exovent Developing Group. (2024) <i>Intensive care medicine</i> <i></i> <i></i> 50: 5 800-801<br/>http://publicationslist.org/exovent/refid112026-04-07T12:22:05ZNegative pressure ventilation protects the brain.van Rijn CM, van Egmond J, Howard D, Coulthard MG, Perella P, Roberts JHM, McKeown D. (2022) <i>Critical care (London, England)</i> <i></i> <i></i> 26: 1 <br/>http://publicationslist.org/exovent/refid92026-04-07T12:26:25ZPerioperative Pulmonary Atelectasis: Comment.We read the review articles by Zeng et al.1 and Lagier et al.2 with great interest, with their emphasis that atelectasis caused by peripheral airway closure is a common complication of mechanical positive pressure ventilation. This phenomenon was first detected during anesthesia by Hedenstierna et al.3,4 and was reviewed by Milic-Emili et al.5 It is well known that negative pleural pressure resolv...<br/><br/>van Egmond J, Speight C, Roberts JHM, Patel A, van Rijn CM, Coulthard M. (2022) <i>Anesthesiology</i> <i></i> <i></i> 137: 1 125-126<br/>http://publicationslist.org/exovent/refid162026-04-07T12:20:47ZNegative pressure ventilation for COVID-19 respiratory failure: a phoenix from the ashes?Howard D, Coulthard MG, Speight C, Grocott M (2022) <i>Arab Board Medical Journal</i> 23: 1 5-13<br/>http://publicationslist.org/exovent/refid182026-04-07T11:48:20ZExovent: a study of a new negative-pressure ventilatory support device in healthy adults.Negative-pressure ventilation may have several advantages compared with positive-pressure ventilation. Negative-pressure ventilation simulates natural lung movements, does not require tracheal intubation and may reduce the incidence of barotrauma and adverse cardiovascular events. A group of engineers, doctors and nurses designed and bench-tested the Exovent, a new, lightweight, torso-only, negati...<br/><br/> The Exovent Development Group (2021) <i>Anaesthesia</i> <i></i> <i></i> 76: 5 623-628<br/>http://publicationslist.org/exovent/refid172026-03-31T20:29:14ZRapid Response to COVID-19: When to start invasive ventilation is “the million dollar question”: a potential role for negative pressure ventilatory support.Speight CG, Howard D, Ackerley D, on behalf of the Exovent Development Group (2021) <i>The British Medical Journal 372 :n121</i> : <br/>