In the mid-20th century, community spaces such as swimming pools and sporting events became a source of anxiety for parents fearful of the spread of the poliovirus. Their concerns were not unfounded. Polio is a debilitating disease that attacks the body’s nervous system, and before the invention of the polio vaccine, it claimed hundreds of thousands of lives each year around the world.
Conceptualized in the late 1920s, the iron lung gained most attention as a first line of defense against polio during the 1948-1955 polio epidemic. This device saved the lives of thousands of patients, mostly children, whose lungs were paralyzed or weakened. According to Harvard Medical School, it protects against polio and aids in breathing.
Although the iron lung has disappeared from modern medicine, its legacy still remains. Here’s why this device has fundamentally changed the way today’s healthcare providers deal with patients facing various types of life-threatening conditions.
What is an iron lung?
The iron lung was a large cylindrical device (up to 6 feet long) that acted as a ventilator to help patients unable to breathe on their own. According to the U.S. Centers for Disease Control and Prevention, patients lie with the device surrounding their body and their head outside the chamber. The iron lung uses negative pressure ventilation (NPV), which “creates a negative pressure around the chest, causing the lungs to expand and draw in air, mimicking natural breathing,” said Dr. explains Dr. Jim Mendez of Nursing. .
For many polio patients, the iron lung was a bridge to survival, said Dr. Daniel Salerno, a professor of pulmonology and critical care at Temple University. Patients were often housed together in large wards. Although many could only rely on an iron lung for a week or two while they recovered, about 1 in 200 polio patients experienced permanent paralysis of their respiratory muscles. These patients were dependent on iron lungs for years and potentially for the rest of their lives, Salerno said.
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Are iron lungs still in use?
Mendez said that since 1955, when the first polio vaccine was approved in the United States, polio cases have declined and the need for iron lungs has declined rapidly.
Paul Alexander, one of the last survivors of America’s iron lung, died in early 2024 at the age of 78. After contracting polio as a child in 1952, Alexander relied on an iron lung for the rest of his life. Despite enduring great physical hardships, Alexander completed further education, worked as a lawyer for 30 years and wrote an autobiography. He shared his amazing story on TikTok, educating his followers about his life in the iron lung and bringing awareness to the millions of children around the world who are currently not vaccinated against polio.
Today, efforts to eradicate polio are global. Since 1988, the number of wild poliovirus infections has declined by more than 99%, but the disease is still considered endemic in two countries: Pakistan and Afghanistan. International organizations have made remarkable progress in implementing polio vaccinations, with more than 20 million people who would have been paralyzed by polio now able to walk, according to the World Health Organization.
Read more: Polio survivor Francis Ford Coppola has harsh words for vaccine opponents
What will replace the iron lung?
At the time of its invention, the iron lung was widely recognized as the most advanced ventilator. Despite its limitations, “this device spurred innovation in ventilator design and emergency medicine, ultimately leading to the development of positive pressure ventilators and other life support systems used in today’s intensive care units.” ,” Mendez said.
While iron lungs used NPV to increase airflow to patients, today’s ventilators use positive pressure ventilation (PPV), Mendez said. Although the iron lung was less invasive than modern technology, it was far less effective at treating acute or respiratory illnesses that require high-pressure support, such as pneumonia, COVID-19, and emphysema, he said. do.
“Additionally,[the iron lung]emphasized the importance of managing respiratory failure, which is a cornerstone of critical care medicine,” Mendez said. “In a wonderful way, these iron lung units were the forerunners of medical ICUs,” Salerno adds. While the ICU has the ability to treat patients facing a wide range of conditions, from gastrointestinal bleeding to kidney failure, its origins remain deeply connected to respiratory medicine, he says.