Nasal positive pressure ventilation is applied by nasal or face mask. It is commonly used for night-time ventilation in neuromuscular disease or obstructive sleep apnea. Positive pressure is applied at intervals or continuously. The former is intermittent positive pressure ventilation and the letter is continous positive airway pressure. The system often used is BiPAP, or bilevel positive airway pressure.Some children tolerate this well but others do not.
Negative pressure ventilation is applied by an iron-lung or by a cuirasse (chest shell). Negative pressure, which results in movement of air the lungs, is applied to the chest. The iron-lung, which saved so many lives in the polio era, has limited use. The cuirasse may be useful in neuromuscular weakness disorders but may worsen obstructive apnea.
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