Copenhagen Polio Epidemic and Intensive Care

At the height of the epidemic, in the summer of 1952, about 50 patients a day were being admitted to Blegdam Hospital, Copenhagen's fever hospital, many of them with paralysis of the breathing muscles or the throat. Too weak to cough, many drowned in their own secretions, and mortality among them reached about 80 percent. For the six to 12 new patients in respiratory failure each day the hospital had one tank respirator, an iron lung, and six cuirass respirators.

The chief physician, Hans Christian Lassen, looked for new ideas. At the suggestion of his deputy, Mogens Bjørneboe, he brought in Bjørn Ibsen, an anesthetist trained in Denmark and the United States. Ibsen proposed ventilating the patients with positive pressure and removing carbon dioxide with an absorber. Lassen at first said no.

On 26 August 1952 Vivi Ebert, a 12-year-old girl, presented with paralysis of all four limbs and failing breathing, and the next day Ibsen was allowed to try his method on her. After a tracheostomy she was ventilated by hand through a rubber bag and improved enough to go onto a cuirass respirator. The hospital adopted the method, and since there were far too few machines it recruited physicians, dentists and students to squeeze the bags around the clock, some patients for weeks. Sources put the number of students anywhere from 200 to about 1,500.

Mortality among these patients fell from 87 percent to about 40 percent. Vivi Ebert needed continuous ventilation until January 1953 and left Blegdam in 1959. The epidemic also forced physiologists to work out what was happening to the gas exchange and acid-base balance of patients breathed for by hand. On 1 August 1953 Ibsen moved to Copenhagen's Municipal Hospital and opened a unit that brought physicians and physiologists together to manage the sickest patients. Kelly and colleagues call it the first intensive care unit in Europe; a 2024 review calls it the world's first multidisciplinary one.