An Automatic Machine for Controlled Respiration

James, Norman R.

doi:10.5694/j.1326-5377.1950.tb80294.x

Cited by 5 publications

(4 citation statements)

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“…In 1952 Clemmesen first documented manual IPPV for the previous year's ten instances of opiate apnoea (after earlier advocating a Waters to-and-fro system for respiratory paralysis in April 1950), but without specifying IPPV for either hypoventilation or apnoea from barbiturate poisoning 40 . Norman James's stance in early 1950 also warrants recognition 51 .…”

Section: Discussionmentioning

confidence: 99%

“…I confess difficulty understanding Clemmesen's seemingly limited recognition of pre-apnoeic consequences from hypoventilation due to barbiturates (contrast this with his adequate treatment of opiate apnoea 20,31 ), or of its compensatory management by artificial ventilation. It can be noted that in Australia in early 1950, Norman James had advocated his own ventilator's suitability for IPPV usage in severe barbiturate poisoning 51 -but he did not document its actual employment. In the 1960s, at Auckland Hospital's ICU, those seriously unconscious received liberal circulatory and ventilatory support, noting that half of Ideström von Reis's patients were not unconscious in 1951 52 .…”

Section: Reservations Concerning Dr Clemmesen's Employment Of Ventilatory Supportmentioning

confidence: 99%

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Pioneering Early Intensive Care Medicine by the ‘Scandinavian Method’ of Treatment for Severe Acute Barbiturate Poisoning

Trubuhovich

2015

Anaesth Intensive Care

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Between the 1920s and the mid-1950s, barbiturates were the sedative-hypnotic agents most used in clinical practice. Their ready availability and narrow therapeutic margin accounted for disturbingly high rates of acute poisoning, whether suicidal or accidental. Until the late 1940s, medical treatment was relatively ineffective, with mortality subsequently high -not only from the effects of coma, respiratory depression and cardiovascular shock with renal impairment, but also from complications of the heavy use in the 1930s and 1940s of analeptic stimulating agents. Incidence of barbiturate intoxication increased substantially following World War II and this paper details development of what became known as the 'Scandinavian Method' of treatment, which contributed substantially to the earliest establishment of intensive care units and to the practice and methods of intensive care medicine. Three names stand out for the pioneering of this treatment. Successively, psychiatrist, Aage Kirkegaard, for introducing effective anti-shock fluid therapy; anaesthetist, Eric Nilsson, for introducing anaesthesiologic principles, including manual intermittent positive pressure ventilation into management; and, psychiatrist, Carl Clemmesen, for introducing centralisation of seriously poisoned patients in a dedicated unit. Clemmesen's Intoxication Unit opened at the Bispebjerg Hospital, Copenhagen, on 1 October 1949. ICU pioneer Bjørn Ibsen suggested it was the initial ICU, while noting that it supplied Intensive Therapy for one type of disorder only (as had HCA Lassen's Blegdam Hospital unit for Denmark's 1952 to 1953 polio epidemic). Treatment for barbiturate poisoning during the 1950s in some other Scandinavian hospitals will also be considered briefly.

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Section: Discussionmentioning

confidence: 99%

Section: Reservations Concerning Dr Clemmesen's Employment Of Ventilatory Supportmentioning

confidence: 99%

Pioneering Early Intensive Care Medicine by the ‘Scandinavian Method’ of Treatment for Severe Acute Barbiturate Poisoning

Trubuhovich

2015

Anaesth Intensive Care

View full text Add to dashboard Cite

show abstract

“…But the introduction of muscle relaxants in 1942 9 and the subsequent alteration in anaesthetic technique proposed by Cecil Gray 10 changed the landscape. Early in 1950, Norman James stated: "The increasing use in anaesthesia of relaxing agents such as "Tubarine" or "Flaxedil" in conjunction with controlled respiration for major surgery tends to focus attention on the possible elimination of manual control with all its disadvantages" 11 .…”

Section: The First Anaesthetic Ventilatorsmentioning

confidence: 99%

“…The apparatus consisted of a sparkless induction motor driving rubber bellows via a gearing mechanism. The pressure was controlled by use of a water manometer, usually kept between 100 to 130 mm of water, which doubled as a safety valve and would "... quickly detect such abuses as the surgeon's assistant using the patient's chest as an arm rest" 11 . The rate of breathing was fixed at 20 per minute but the tidal volume could be changed by a small handwheel.…”

Section: The First Anaesthetic Ventilatorsmentioning

confidence: 99%