Recent advances in mechanical ventilation:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1996
|
| Schriftenreihe: | Clinics in chest medicine
17,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 355 - 619 Ill., graph. Darst. |
Internformat
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| 245 | 1 | 0 | |a Recent advances in mechanical ventilation |c Avi Nahum ... guest ed. |
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| 650 | 2 | |a Respirateur artificiel | |
| 650 | 7 | |a Vooruitgang |2 gtt | |
| 650 | 4 | |a Breathing apparatus | |
| 650 | 4 | |a Respirators (Medical equipment) | |
| 650 | 4 | |a Respiratory therapy | |
| 650 | 4 | |a Ventilators | |
| 650 | 4 | |a Ventilators, Mechanical | |
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Datensatz im Suchindex
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| adam_text | RECENT ADVANCES IN MECHANICAL VENTILATION
CONTENTS
Preface xi
Avi Nahum and John J. Marini
Intubation of Critically 111 Patients 355
Sandralee A. Blosser and John L. Stauffer
Intubation of the airway is the first and foremost step in care of the
critically ill patient requiring mechanical ventilation. During the last de¬
cade, options for airway management, particularly in the patient with a
difficult airway, have expanded substantially. New devices, techniques,
and pharmacologic agents to facilitate intubation have emerged. Our un¬
derstanding of the complications and limitations of translaryngeal intuba¬
tion and tracheotomy has also evolved. The purpose of this article is to
incorporate this new information into a base of current and practical
knowledge of intubation of the critically ill adult patient.
Auto Positive End Expiratory Pressure and Dynamic Hyperinflation 379
V. Marco Ranieri, Salvatore Grasso, Tommaso Fiore, and Rocco Giuliani
Deviation of end expiratory lung volume from the elastic equilibrium
volume of the respiratory system is recognized as a cardinal feature in
mechanically ventilated patients with severe chronic obstructive pulmo¬
nary disease (COPD) and acute asthma. The presence of dynamic hyperin¬
flation implies that alveolar pressure remains positive throughout expira¬
tion. At the end of the expiration, this positive difference between alveolar
and external airway pressures is termed auto positive end expiratory pres¬
sure (PEEP) or intrinsic PEEP. The aims of this article are (1) to review
the physiologic mechanisms of auto PEEP and the use of PEEP in counter¬
balancing auto PEEP and (2) to examine the clinical criteria for application
of PEEP in patients with COPD.
Pressure Controlled and Volume Cycled Mechanical Ventilation 395
Andrew W. McKibben and Sue A. Ravenscraft
Pressure and volume modes of mechanical ventilation are available as
options in the current generation of ventilators, giving clinicians many
choices when managing a mechanically ventilated patient. In volume
CUNJCS IN CHEST MEDICINE
VOLUME 17 • NUMBER 3 • SEPTEMBER 1996 vii
cycled ventilation, tidal volume is set and airway pressures are measured,
whereas in pressure controlled ventilation, pressure is set and volume is
measured. This article reviews the characteristics of these two ventilatory
modes and discusses in detail conversion from one mode to the other.
Pertinent clinical studies and recent direct comparisons of volume cycled
and pressure controlled ventilation are reviewed.
New Modes of Mechanical Ventilation 411
Neil R. Maclntyre
Many new approaches to mechanical ventilation have been developed.
This article discusses these new strategies and modes. These include lung
protection conventional ventilation strategies, long inspiratory time strate¬
gies, pressure targeted breath enhancements, airway pressure related re¬
lease ventilation, and proportional assist ventilation.
Patient Ventilator Interactions 423
Cameron R. Dick and Catherine S. H. Sassoon
Patient ventilator synchrony is important in the management of the venti¬
lator dependent patient. Factors inherent to the patient and the ventilator
influence patient ventilator synchrony. Detection of patient ventilator
synchrony may require monitoring of airway pressure and flow wave¬
forms.
Complications of Mechanical Ventilation: A Bedside Approach 439
Robert L. Keith and David J. Pierson
The initiation of mechanical ventilation may be associated with multiple
complications that occur in many patients. In a problem oriented analysis,
the adverse effects can be divided into those encountered in a newly
intubated patient and those that develop in a previously stable patient.
The physician may be consulted for a variety of new developments. The
diagnosis of ventilator associated pneumonia remains difficult, with a
variety of procedures and culture techniques designed to improve sensitiv¬
ity and specificity. This novel approach to clinical problem solving in the
ICU will reduce the likelihood of missed diagnoses and allow for an
analysis based on pathophysiology
Monitoring During Mechanical Ventilation 453
Amal Jubran and Martin J. Tobin
Approximately half of the patients admitted to an ICU are admitted for
the purposes of monitoring rather than interventional therapy. In the
last decade, significant technologic advances have enhanced monitoring
capacities, and the understanding of the pathophysiology of respiratory
failure has improved pari passu, allowing clinicians to employ monitors
in a more intelligent manner. This article deals with new developments in
arterial blood gas monitoring, pulse oximetry, capnometry, and monitor¬
ing of neuromuscular function and pulmonary mechanics, emphasizing
issues most relevant to mechanical ventilation.
Weaning from Ventilatory Support 475
Martin R. Lessard and Laurent J. Brochard
In many patients, resumption of spontaneous breathing after an episode
of acute respiratory failure may be a prolonged and difficult process,
accounting for a significant proportion of the total duration of mechanical
ventilation. This article reviews the criteria used to predict the ability of
the patient to be weaned from mechanical ventilation and discusses the
Viii CONTENTS
causes of difficult weaning and the different methods of weaning. Future
directions in the management of weaning from mechanical ventilation are
addressed.
Adjuncts to Mechanical Ventilation 491
Avi Nahum and Robert Shapiro
Adjunctive ventilatory strategies have been developed to improve oxygen
ation and carbon dioxide (CO2) removal during mechanical ventilation of
critically ill patients. These techniques allow clinicians to attain their clini¬
cal goals at lower levels of ventilatory support. In this article, the authors
discuss extracorporeal CO2 removal, venovenous intravena caval oxygena
tor, and tracheal gas insufflation as adjuncts to CO2 removal and nitric
oxide, surfactant replacement therapy, perfluorocarbon associated gas ex¬
change, and prone positioning as adjuncts to oxygenation.
Noninvasive Positive Pressure Ventilation
in Patients with Acute Respiratory Failure 513
G. Umberto Meduri
This article provides a systematic review of the literature on the applica¬
tion of noninvasive ventilation in various forms of hypercapnic and hypox
emic respiratory failures. A description of the underlying pathophysiology
is followed by a review of physiologic data explaining the mechanisms of
action of noninvasive ventilation. A critical review of clinical studies is
presented with specific suggestions. The methodology of correctly imple¬
menting and monitoring noninvasive ventilation in patients with acute
respiratory failure, critical to success, is detailed.
Evolving Concepts in the Ventilatory Management
of Acute Respiratory Distress Syndrome 555
John J. Marini
With few modifications, a high tidal volume, normoxic, normocapnic
ventilation paradigm developed as the standard approach to supporting
most critically ill patients. Large tidal volumes, high end tidal (plateau)
alveolar pressures, and low levels of positive end expiratory pressure are
still common in many ICUs during ventilation of acute respiratory distress
syndrome (ARDS). A body of scientific literature now suggests that this
traditional approach may retard healing of the injured lung. A relatively •
small but growing number of practitioners are shifting their first priority
from optimizing oxygen exchange, oxygen delivery, or respiratory system
compliance to ensuring adequate lung protection. This article reviews the
basis for concern about traditional ventilatory support in ARDS and devel¬
ops an approach based on current evidence and newer options for man¬
agement.
Mechanical Ventilation in Obstructive Lung Disease 577
James W. Leatherman
This article reviews selected topics relevant to the use of mechanical
ventilation in patients with severe airflow obstruction. Areas discussed
include the bedside assessment of respiratory system mechanics, the venti¬
latory determinants of dynamic pulmonary hyperinflation, the role of
controlled hypoventilation with permissive hypercapnia, and the delivery
of bronchodilators during mechanical ventilation.
Independent Lung Ventilation 591
David Ost and Thomas Corbridge
This article reviews techniques of lung separation, focusing on the use of
double lumen endotracheal tubes (DLT). DLT design placement, monitor
CONTENTS ix
ing, and complications are reviewed, and clinical considerations in inde¬
pendent lung ventilation are discussed. Situations in which independent
lung ventilation may be of use are evaluated, including massive hemopty¬
sis, pulmonary alveolar proteinosis, risk of interbronchial aspiration, uni¬
lateral lung injury, single lung transplant, and bronchopleural fistula.
Mechanical Ventilation of the Newborn: An Overview 603
Mark C. Mammel and Dennis R. Bing
This article provides a short overview of mechanical ventilation in new¬
born infants. The authors review the history of newborn respiratory treat¬
ment, discuss the pathophysiologic differences of newborns, and look at
the use of specialized equipment in the field. Conventional infant ventila¬
tors, which are pressure preset, time cycled devices, now allow accurate
tidal volume measurement and patient synchronization. High frequency
ventilation is now a standard part of newborn respiratory care. The new
application of synchronized ventilation modes in infants, along with im¬
proving computer assisted gas flow analysis systems incorporated into
new ventilators, is changing clinical practice rapidly.
Index 615
Subscription Information Inside back cover
X CONTENTS
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| spelling | Recent advances in mechanical ventilation Avi Nahum ... guest ed. Philadelphia [u.a.] Saunders 1996 XII S., S. 355 - 619 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Clinics in chest medicine 17,3 Apparatuur gtt Beademing gtt Respirateur artificiel Vooruitgang gtt Breathing apparatus Respirators (Medical equipment) Respiratory therapy Ventilators Ventilators, Mechanical Künstliche Beatmung (DE-588)4033439-9 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Künstliche Beatmung (DE-588)4033439-9 s DE-604 Nahum, Avi Sonstige oth Clinics in chest medicine 17,3 (DE-604)BV000001084 17,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007346778&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Recent advances in mechanical ventilation |
| title_auth | Recent advances in mechanical ventilation |
| title_exact_search | Recent advances in mechanical ventilation |
| title_full | Recent advances in mechanical ventilation Avi Nahum ... guest ed. |
| title_fullStr | Recent advances in mechanical ventilation Avi Nahum ... guest ed. |
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| title_short | Recent advances in mechanical ventilation |
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