Böttinger and Van der Hoorn. Negative pressure ventilation – a special application of expiratory ventilation assistance. Intensive Care Med Exp 2019, 7(1), 22

This ‘letter to the editor’ refers to the publication by Berlin et al. in Intensive Care Med Exp 2019, which demonstrated improved hemodynamic parameters during EVA ventilation with negative end-expiratory pressure (NEEP) versus VCV in a porcine model for hypovolemia after hemorrhage. Here, it is pointed out that use of EVA-NEEP represents a very specific application the EVA/FCV ventilation concepts that may only be indicated in situations of hemorrhagic shock. In contrast, EVA/FCV ventilation with PEEP was proven to represent a higher efficient alternative compared to conventional ventilation methods, as demonstrated by pre-clinical and clinical studies.