Pilbeam's mechanical ventilation : physiological and clinical applications / J.M. Cairo.

Rev. ed. of: Mechanical ventilation / Susan P. Pilbeam, J.M. Cairo, c2006.

Includes bibliographical references and index.

Contents note continued: 4.Establishing the Need for Mechanical Ventilation -- Acute Respiratory Failure -- Patient History and Diagnosis -- Physiological Measurements in Acute Respiratory Failure -- Overview of Criteria for Mechanical Ventilation -- Possible Alternatives to Invasive Ventilation -- 5.Selecting the Ventilator and the Mode -- Noninvasive and Invasive Positive-Pressure Ventilation: Selecting the Patient Interface -- Full and Partial Ventilatory Support -- Mode of Ventilation and Breath Delivery -- Breath Delivery and Modes of Ventilation -- Bilevel Positive Airway Pressure -- Additional Modes of Ventilation -- 6.Initial Ventilator Settings -- Determining Initial Ventilator Setting During Volume-Controlled Ventilation -- Initial Settings During Volume-Controlled Ventilation -- Setting Minute Ventilation -- Setting the Minute Ventilation: Special Considerations -- Inspiratory Pause During Volume Ventilation --

Contents note continued: Determining Initial Ventilator Settings During Pressure Ventilation -- Setting Baseline Pressure---Physiological PEEP -- Initial Settings for Pressure Ventilation Modes with Volume Targeting -- 7.Final Considerations in Ventilator Setup -- Selection of Additional Parameters and Final Ventilator Setup -- Selection of Fractional Concentration of Inspired Oxygen F1O2 -- Sensitivity Setting -- Alarms -- Periodic Hyperinflation or Sighing -- Final Considerations in Ventilator Equipment Setup -- Selecting the Appropriate Ventilator -- Evaluation of Ventilator Performance -- Initial Ventilator Settings for Specific Patient Situations -- Chronic Obstructive Pulmonary Disease -- Neuromuscular Disorders -- Asthma -- Closed Head Injury -- Acute Respiratory Distress Syndrome -- Acute Cardiogenic Pulmonary Edema and Congestive Heart Failure -- pt. 3 MONITORING IN MECHANICAL VENTILATION -- 8.Initial Patient Assessment --

Contents note continued: Documentation of the Patient-Ventilator System -- The First 30 Minutes -- Monitoring Airway Pressures -- Vital Signs, Blood Pressure, and Physical Examination of the Chest -- Management of Endotracheal and Tracheostomy Tube Cuffs -- Monitoring Compliance and Airway Resistance -- Comment Section of the Ventilator Flow Sheet -- 9.Ventilator Graphics -- Relationship of Volume, Flow, Pressure and Time -- Volume-Controlled Ventilation with Constant Flow -- Producing Ventilator Graphics -- Calculations -- A Closer Look at the Flow-Time Scalar in Volume-Controlled Continuous Mandatory Ventilation -- Changes in the Pressure-Time Curve -- Volume Scalar -- Key Points of Volume-Controlled Ventilation Graphics -- Pressure-Controlled Ventilation -- Pressure-Controlled Ventilation with a Constant Pressure Waveform -- Key Points of Pressure-Controlled Ventilation Graphics -- Pressure Support Ventilation --

Contents note continued: Details of the Pressure-Time Waveform in Pressure-Support Ventilation -- Flow Cycling During Pressure-Support Ventilation -- Automatic Adjustment of the Flow-Cycle Criterion -- Use of Pressure-Support Ventilation with SIMV -- Pressure-Volume Loops -- Pressure-Volume Loop and Work of Breathing -- Troubleshooting a Pressure-Volume Loop -- Flow-Volume Loops During Mechanical Ventilation -- Components of an Flow-Volume Loop with Mandatory Breaths -- Troubleshooting with Flow-Volume Loops During Mechanical Ventilation -- 10.Assessment of Respiratory Function -- Noninvasive Measurements of Blood Gases -- Pulse Oximetry -- Capnography (Capnometry) -- Exhaled Nitric Oxide Monitoring -- Transcutaneous Monitoring -- Indirect Calorimetry and Metabolic Measurements -- Overview of Indirect Calorimetry -- Assessment of Respiratory System Mechanics -- Measurements -- 11.Hemodynamic Monitoring -- Review of Cardiovascular Principles --

Contents note continued: Obtaining Hemodynamic Measurements -- Interpretation of Hemodynamic Profiles -- Clinical Applications -- pt. 4 THERAPEUTIC INTERVENTIONS---MAKING APPROPRIATE CHANGES -- 12.Methods to Improve Ventilation in Patient-Ventilator Management -- Correcting Ventilation Abnormalities -- Common Methods of Changing Ventilation Based on PaCO2 and pH -- Metabolic Acidosis and Alkalosis -- Mixed Acid-Base Disturbances -- Increased Physiological Dead Space -- Increased Metabolism and Increased Carbon Dioxide Production -- Intentional Iatrogenic Hyperventilation -- Permissive Hypercapnia -- Airway Clearance During Mechanical Ventilation -- Secretion Clearance from an Artificial Airway -- Administering Aerosols to Ventilated Patients -- Postural Drainage and Chest Percussion -- Flexible Fiberoptic Bronchoscopy -- Additional Patient Management Techniques and Therapies in Ventilated Patients -- Importance of Body Position and Positive-Pressure Ventilation --

Contents note continued: Sputum and Upper Airway Infections -- Fluid Balance -- Psychological and Sleep Status -- Patient Safety and Comfort -- Transport of Mechanically Ventilated Patients Within an Acute Care Facility -- 13.Improving Oxygenation and Management of Acute Respiratory Distress Syndrome / J.M. Cairo -- Basics of Oxygenation Using F1O2, PEEP Studies, and Pressure-Volume Curves for Establishing Optimum PEEP -- Basics of Oxygen Delivery to the Tissues -- Introduction to Positive End-Expiratory Pressure and Continuous Positive Airway Pressure -- PEEP Ranges -- Indications for PEEP and CPAP -- Initiating PEEP Therapy -- Selecting the Appropriate PEEP/CPAP Level (Optimum PEEP) -- Use of Pulmonary Vascular Pressure Monitoring with PEEP -- Contraindications and Physiological Effects of PEEP -- Weaning from PEEP -- Acute Respiratory Distress Syndrome -- Pathophysiology -- Changes in Computed Tomogram with ARDS -- ARDS as an Inflammatory Process --

Contents note continued: PEEP and the Vertical Gradient in ARDS -- Lung Protective Strategies: Setting Tidal Volume and Pressures in ARDS -- Long-Term Follow-Up on ARDS -- Pressure-Volume Loops and Recruitment Maneuvers in Setting PEEP in ARDS -- pt. 5 EFFECTS AND COMPLICATIONS OF MECHANICAL VENTILATION -- 14.Ventilator-Associated Pneumonia -- Epidemiology -- Pathogenesis of Ventilator-Associated Pneumonia -- Diagnosis of Ventilator-Associated Pneumonia -- Treatment of Ventilator-Associated Pneumonia -- Strategies to Prevent Ventilator-Associated Pneumonia -- 15.Sedatives, Analgesics, and Paralytics -- Sedatives and Analgesics -- Paralytics -- 16.Extrapulmonary Effects of Mechanical Ventilation -- Effects of Positive-Pressure Ventilation on the Heart and Thoracic Vessels -- Adverse Cardiovascular Effects of Positive-Pressure Ventilation -- Factors Influencing Adverse Cardiovascular Effects of Positive-Pressure Ventilation --

Contents note continued: Beneficial Effects of Positive-Pressure Ventilation on Heart Function in Patients with Left Ventricular Dysfunction -- Minimizing the Physiological Effects and Complications of Mechanical Ventilation -- Effects of Mechanical Ventilation on Intracranial Pressure, Renal Function, Liver Function, and Gastrointestinal Function -- Effects of Mechanical Ventilation on Intracranial Pressure and Cerebral Perfusion -- Renal Effects of Mechanical Ventilation -- Effects of Mechanical Ventilation on Liver and Gastrointestinal Function -- Nutritional Complications During Mechanical Ventilation -- 17.Effects of Positive-Pressure Ventilation on the Pulmonary System -- Lung Injury with Mechanical Ventilation -- Effects of Mechanical Ventilation on Gas Distribution and Pulmonary Blood Flow -- Respiratory and Metabolic Acid-Base Status in Mechanical Ventilation -- Air Trapping (Auto-PEEP) -- Hazards of Oxygen Therapy with Mechanical Ventilation --

Contents note continued: Increased Work of Breathing -- Ventilator Mechanical and Operational Hazards -- Complications of the Artificial Airway -- 18.Troubleshooting and Problem Solving / Theresa A. Gramlich -- Definition of the Term Problem -- Protecting the Patient -- Identifying the Patient in Sudden Distress -- Patient-Related Problems -- Ventilator-Related Problems -- Common Alarm Situations -- Use of Graphics to Identify Ventilator Problems -- Unexpected Ventilator Responses -- pt. 6 NONINVASIVE POSITIVE PRESSURE VENTILATION -- 19.Basic Concepts of Noninvasive Positive-Pressure Ventilation / Theresa A. Gramlich -- Types of Noninvasive Ventilation Techniques -- Goals and Indications for Noninvasive Positive-Pressure Ventilation -- Other Indications for NIV -- Patient Selection Criteria -- Equipment Selection for NIV -- Setup and Preparation for NIV -- Monitoring and Adjusting NIV -- Aerosol Delivery in NIV -- Complications of NIV -- Weaning from and Discontinuing NIV --

Contents note continued: Patient Care Team Concerns -- pt. 7 DISCONTINUATION FROM VENTILATION AND LONG-TERM VENTILATION -- 20.Weaning and Discontinuation from Mechanical Ventilation -- Weaning Techniques -- Methods of Titrating Ventilator Support During Weaning -- Closed-Loop Control Modes for Ventilator Discontinuation -- Evidence-Based Weaning -- Evaluation of Clinical Criteria for Weaning -- Recommendation 1 Pathology of Ventilator Dependence -- Recommendation 2 Assessment of Readiness for Weaning Using Evaluation Criteria -- Recommendation 3 Assessment During a Spontaneous Breathing Trial -- Recommendation 4 Removal of the Artificial Airway -- Factors in Weaning Failure -- Recommendation 5 Spontaneous Breathing Trial Failure -- Nonrespiratory Factors That May Complicate Weaning -- Recommendation 6 Maintaining Ventilation in Patients with Spontaneous Breathing Trial Failure -- Final Recommendations -- Recommendation 7 Anesthesia and Sedation Strategies and Protocols --

Contents note continued: Recommendation 8 Weaning Protocols -- Recommendation 9 Role of Tracheostomy in Weaning -- Recommendation 10 Long-Term Care Facilities for Patients Requiring Prolonged Ventilation -- Recommendation 11 Clinician Familiarity with Long-Term Care Facilities -- Recommendation 12 Weaning in Long-Term Ventilation Units -- Ethical Dilemma: Withholding and Withdrawing Ventilatory Support -- 21.Long-Term Ventilation / Theresa A. Gramlich -- Goals of Long-Term Mechanical Ventilation -- Sites for Ventilator-Dependent Patients -- Patient Selection -- Preparation for Discharge to the Home -- Follow-Up and Evaluation -- Equipment Selection for Home Ventilation -- Complications of Long-Term Positive-Pressure Ventilation -- Alternatives to Invasive Mechanical Ventilation at Home -- Expiratory Muscle Aids and Secretion Clearance -- Tracheostomy Tubes, Speaking Valves, and Tracheal Buttons -- Ancillary Equipment and Equipment Cleaning for Home Mechanical Ventilation --

Contents note continued: pt. 8 NEONATAL AND PEDIATRIC RESPIRATORY SUPPORT -- 22.Neonatal and Pediatric Mechanical Ventilation / Robert M. DiBlasi -- Recognizing the Need for Mechanical Ventilatory Support -- Goals of Newborn and Pediatric Ventilatory Support -- Noninvasive Respiratory Support -- Conventional Mechanical Ventilation -- High-Frequency Ventilation -- Weaning and Extubation -- Adjunctive Forms of Respiratory Support -- pt. 9 SPECIAL APPLICATIONS IN VENTILATORY SUPPORT -- 23.Special Techniques in Ventilatory Support / Paul Barraza -- Airway Pressure-Release Ventilation -- Other Names -- Advantages of APRV Compared with Conventional Ventilation -- Disadvantages -- Initial Settings -- Adjusting Ventilation and Oxygenation -- Discontinuation -- High-Frequency Oscillatory Ventilation in the Adult -- Technical Aspects -- Initial Control Settings -- Indication and Exclusion Criteria -- Monitoring, Assessment, and Adjustment --

Contents note continued: Adjusting Settings to Maintain Arterial Blood Gas Goals -- Returning to Conventional Ventilation -- Heliox Therapy and Mechanical Ventilation -- Gas Flow Through the Airways -- Heliox in Avoiding Intubation and During Mechanical Ventilation -- Postextubation Stridor -- Devices for Delivering Heliox in Spontaneously Breathing Patients -- Manufactured Heliox Delivery System -- Heliox and Aerosol Delivery During Mechanical Ventilation -- Monitoring the Electrical Activity of the Diaphragm and Neurally Adjusted Ventilatory Assist -- Review of Neural Control of Ventilation -- Diaphragm Electrical Activity Monitoring -- Neurally Adjusted Ventilatory Assist.

Applying mechanical ventilation principles to patient care, this 5th Edition helps you provide safe, appropriate, and compassionate care for patients requiring ventilatory support. A focus on evidence-based practice includes the latest techniques and equipment, with complex ventilator principles simplified for optimal learning. This edition adds new case studies and new chapters on ventilator-associated pneumonia and on neonatal and pediatric mechanical ventilation. Starting with the most fundamental concepts and building to the most advanced, expert educator J. M. Cairo presents clear, comprehensive, up-to-date coverage of the rapidly evolving field of mechanical ventilation. Excerpts of Clinical Practice Guidelines developed by the AARC (American Association for Respiratory Care) make it easy to access important information regarding indications/contraindications, hazards and complications, assessment of need, assessment of outcome, and monitoring. NBRC exam-style assessment questions at the end of each chapter offer practice for the certification exam. NEW Neonatal and Pediatric Mechanical Ventilation chapter covers the latest advances and research relating to young patients. Additional case studies in each chapter present "real-life" scenarios, showing the practical application of newly acquired skills. End-of-chapter summaries help with review and in assessing your comprehension with a bulleted list of key content.