The use of home mechanical ventilation has increasingly become commonplace in the management of patients with chronic neuromuscular ventilatory failure. Numerous approaches to the application of ventilatory support, both invasive and noninvasive, are currently available. These range from providing standard invasive intermittent positive pressure mechanical ventilation (IPPV) via an indwelling tracheostomy tube to the use of negative pressure body ventilators (NPBVs), intermittent abdominal pressure ventilators (IAPVs), rocking beds, and noninvasive IPPV techniques. This paper discusses the technical operation and limitations of current positive pressure ventilators. Additionally, clinical application methodology in various settings is detailed.
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