Monday Keynote Recounts Gripping Developments of Mechanical Ventilation and Intensive Care Units

Only several years removed from the peak of the COVID-19 pandemic, it’s difficult to imagine the world of health care before the emergence of mechanical ventilation and the development of intensive care units. However, these tools and techniques that many now take for granted as familiar aspects of the health care landscape are not nearly as archaic as one might expect.

Hannah Wunsch, MD, M.Sc.
Hannah Wunsch, MD, MSc

Hannah Wunsch, MD, MSc, a critical care doctor, professor at Weill Cornell Medicine, and author, has traced the crucial innovations of mechanical ventilation and ICUs back to a polio epidemic in the autumn of 1952 and turned her research into a suspenseful and authoritative account of a revolution in medical care in her book, The Autumn Ghost: How the Battle Against a Polio Epidemic Revolutionized Modern Medical Care.

Dr. Wunsch will explore the history of modern mechanical ventilation and the first ICU during Monday’s Keynote Lecture from 8-8:45 a.m. PT in the San Diego Convention Center.

Dr. Wunsch’s extensive research draws testimony from doctors, nurses, medical students, and patients to compile a gripping narrative that captures how a group of insiders and iconoclasts came together inside an overwhelmed Copenhagen hospital to save their many polio patients dying of respiratory failure.

“I wanted to share this story with our medical community and also write a book that would help people outside of medicine to understand the importance of these advances and what they have done for us in terms of medical care over the years,” Dr. Wunsch explained. “What’s astonishing is how recent these developments are. What it meant to be critically ill before these innovations, and the lack of useful interventions or care techniques is hard to fathom.”

While she started writing the book before COVID-19 emerged, the parallels between the pandemic and the polio epidemic Dr. Wunsch was covering were hard to ignore.

“I went from feeling like I was going to need to convince the world that they should even care about mechanical ventilation as a concept to feeling an amplified responsibility to convey how incredible it is that we have mechanical ventilation and what it took for the people involved to figure out this intervention,” she said.

In both instances, desperation became a driver for innovation. In light of the dire circumstances, the head of the Copenhagen hospital at the center of Dr. Wunsch’s book, who was considered a leading expert on the epidemiology of polio at the time, brought in an outsider whose discoveries ultimately unlocked the mysteries of polio’s effects on patients’ bodies.

“It was an anesthesiologist who had never cared for a polio patient who recognized that people with bulbar polio were dying due to respiratory failure and carbon-dioxide build-up and that this was the thing that needed to be fixed to save these individuals,” Dr. Wunsch explained. “The team needed someone who did not have the received wisdom about polio to come in with an understanding of respiratory physiology that other people at the bedside didn’t have.”

Dr. Wunsch expounded that this lesson speaks to the need for diversity and inclusivity in clinical care and research teams today.

Another parallel drawn between COVID-19 and the polio epidemic is the importance of care and advocacy after the zenith of social disease activity.

“Polio is still an active disease, with many survivors struggling with post-polio syndrome,” Dr. Wunsch said. “With recent reductions in vaccine uptake, there is the threat that this disease – that none of us have been trained to take care of – could have a resurgence, if we’re not careful to ensure adequate vaccination rates.”

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