Clinical Application of Mechanical Ventilation

Name: Clinical Application of Mechanical Ventilation
Price: 3.98 USD
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ISBN: 9781401884857

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.

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