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Clinical Application of Mechanical Ventilation

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ISBN-10: 1401884857

ISBN-13: 9781401884857

Edition: 3rd 2006 (Revised)

Authors: David W. Chang

List price: $257.95
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With a concise and easy-to-read approach, the new edition of this book integrates the essential concepts of respiratory physiology with the clinical application of mechanical ventilation. Extensive coverage of airway management and weaning criteria, and a concise view of pharmacotherapy for mechanical ventilation are included. Each chapter features visual examples illustrating concepts, key points summarized in margin references, and assessment questions written in NRBC format, to help prepare learners to sit for the exam. Fifteen case studies enable learners to apply theoretical knowledge to real-world critical thinking situations they may face in the field.
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Book details

List price: $257.95
Edition: 3rd
Copyright year: 2006
Publisher: Delmar Cengage Learning
Publication date: 9/6/2005
Binding: Paperback
Pages: 720
Size: 7.75" wide x 9.50" long x 1.00" tall
Weight: 2.398
Language: English

Foreword
Preface
Acknowledgments
Contributors
Principles of Mechanical Ventilation
Introduction
Airway Resistance
Lung Compliance
Deadspace Ventilation
Ventilatory Failure
Oxygenation Failure
Clinical Conditions Leading to Mechanical Ventilation
Effects of Positive Pressure Ventilation
Introduction
Pulmonary Considerations
Cardiovascular Considerations
Hemodynamic Considerations
Renal Considerations
Hepatic Considerations
Abdominal Considerations
Nutritional Considerations
Neurological Considerations
Classification of Mechanical Ventilators
Introduction
Ventilator Classification
Ventilatory Work
Input Power
Drive Mechanism
Control Circuit
Control Variables
Phase Variables
Output Waveforms
Alarm Systems
Operating Modes of Mechanical Ventilation
Introduction
Negative and Positive Pressure Ventilation
Operating Modes of Mechanical Ventilation
Spontaneous
Positive End-Expiratory Pressure (PEEP)
Continuance Positive Airway Pressure (CPAP)
Bi-level Positive Airway Pressure (BIPAP)
Controlled Mandatory Ventilation (CMV)
Assist Control (AC)
Intermittent Mandatory Ventilation (IMV)
Synchronized Intermittent Mandatory Ventilation (SIMV)
Mandatory Minute Ventilation (MMV)
Pressure Support Ventilation (PSV)
Pressure Control Ventilation (PCV)
Proportional Assist Ventilation
Airway Pressure Release Ventilation (APRV)
Inverse Ratio Ventilation (IRV)
Temporary Airways for Ventilation
Introduction
Esophageal Obturator Airway (EOA)
Esophageal Gastric Tube Airway (EGTA)
Laryngeal Mask Airway (LMA)
Pharyngealtracheal Lumen Airway (PTLA)
Airway Management in Mechanical Ventilation
Introduction
Intubation
Common Artificial Airways in Mechanical Ventilation
Intubation Procedure
Management of Endotracheal and Tracheostomy Tubes
Extubation
Complications of Endotracheal Intubation
Noninvasive Positive Pressure Ventilation
Introduction
Terminology
Use of Continuous Positive Airway Pressure (CPAP)
Use of Bilevel Positive Airway Pressure (Bilevel PAP)
Common Interfaces for CPAP and Bilevel PAP
Potential Problems with Interfaces
Titration of Continuous Positive Airway Pressure
Titration of Bilevel Positive Airway Pressure
Initiation of Mechanical Ventilation
Introduction
Indications
Contraindications
Initial Ventilator Settings
Ventilator Alarm Settings
Hazards and Complications
Monitoring in Mechanical Ventilation
Introduction
Vital Signs
Chest Inspection and Auscultation
Fluid Balance and Anion Gap
Arterial Blood Gases
Oxygen Saturation Monitoring
End-Tidal Carbon Dioxide Monitoring
Transcutaneous Blood Gas Monitoring
Hemodynamic Waveform Analysis
Introduction
Hemodynamic Monitoring
Arterial Catheter
Central Venous Catheter
Pulmonary Artery Catheter
Summary of Preloads and Afterloads
Calculated Hemodynamic Values
Monitoring of Mixed Venous Oxygen Saturation
Basic Ventilator Waveform Analysis
Introduction
Flow Waves Used for Positive Pressure Ventilation
Effects of Constant Flow during Volume-controlled Ventilation
Spontaneous Ventilation during Mechanical Ventilation
Effects of Flow, Circuit, and Lung Characteristics on Pressure-time Waveforms
Effects of Decelerating Flow during Volume-Controlled Ventilation
Waveforms Developed during Pressure-limited Ventilation
Pressure Support and Spontaneous Modes of Ventilation
Effects of Lung Characteristics on Pressure-limited Waveforms
Using Waveforms for Patient and Ventilator-system Assessment
Using the Expiratory Flow and Pressure Waves as Diagnostic Tools
Troubleshooting Ventilator Function
Pressure-volume and Flow-volume Curves or Loops
Management of Mechanical Ventilation
Introduction
Strategies to Improve Ventilation
Strategies to Improve Oxygenation
Acid-base Balance
Troubleshooting of Common Ventilator Alarms and Events
Care of the Ventilator Circuit
Care of the Artificial Airway
Fluid Balance
Electrolyte Balance
Nutrition
Pharmacotherapy for Mechanical Ventilation
Introduction
Drugs for Improving Ventilation
Delivery of MDI Medications
Neuromuscular Blocking Agents
Sedatives and Antianxiety Agents (Benzodiazepines)
Narcotic Analgesics
Agents for Seizures and Elevated Intracranial Pressure (Barbiturates)
Other Agents Used in Mechanical Ventilation
Weaning From Mechanical Ventilation
Introduction
Definition of Weaning Success and Failure
Patient Condition Prior to Weaning
Weaning Criteria
Combined Weaning Indices
Weaning Procedure
Signs of Weaning Failure
Causes of Weaning Failure
Terminal Weaning
Neonatal Mechanical Ventilation
Introduction
Intubation
Surfactant Replacement Therapy
Basic Principles of Neonatal Ventilation
Initiation of Neonatal Ventilator Support
High Frequency Ventilation (HFV)
Other Methods of Ventilation
Extracorporeal Membrane Oxygenation (ECMO)
Home Mechanical Ventilation
Introduction
Goals of Home Mechanical Ventilation
Indications
Patient Selection
Equipment Selection
Learning Objectives for Positive Pressure Ventilation in the Home
Case Studies
COPD
Status Asthmaticus
Postabdominal Surgery
Head Injury
Smoke Inhalation
Drug Overdose
Tension Hemopneumothorax
Chest Trauma
Adult Respiratory Distress Syndrome
Myasthenia Gravis
Guillain-Barre
Botulism
Meconium Aspiration/Patent Ductus Arteriosus
Persistent Pulmonary Hypertension of the Newborn
Home Care and Disease Management
Respiratory Care Calculations
Airway Resistance: Estimated (R[subscript aw])
Alveolar-Arterial Oxygen Tension Gradient: P(A - a)O[subscript 2]
Anion Gap
Compliance: Dynamic (C[subscript dyn])
Compliance: Static (C[subscript st])
Corrected Tidal Volume (V[subscript T])
Deadspace to Tidal Volume Ratio (V[subscript D]/V[subscript T])
Mean Airway Pressure (MAWP)
Minute Ventilation: Expired and Alveolar
Shunt Equation (Q[subscript sp]/Q[subscript T]): Classic Physiologic
Shunt Equation (Q[subscript sp]/Q[subscript T]): Estimated
Ventilator Rate Needed for a Desired PaCO[subscript 2]
Weaning Index: Rapid Shallow Breathing
Weaning Index: Simplified
Dubois Body Surface Chart
Pressure Conversions
French (Fr) and Millimeter (mm) Conversions
Normal Electrolyte Concentrations in Plasma
Oxygen Transport Normal Ranges
Hemodynamic Normal Ranges
Index