Ebook Inderbir singh textbook of anatomy (3/E): Part 1
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Contents
Preface
Abbreviations
Part1PrinciplesofMechanicalVentilation
Chapter1PhysiologicEffectsofMechanicalVentilation
Chapter2PhysiologicGoalsofMechanicalVentilation
Chapter3Ventilator-InducedLungInjury
Chapter4Ventilator-AssociatedPneumonia
Chapter5VentilatorModeClassification
Chapter6TraditionalModesofMechanicalVentilation
Chapter7PressureandVolumeVentilation
Chapter8AdvancedModesofMechanicalVentilation
Chapter9FlowWaveformsandI:ERatios
Chapter10HighFrequencyVentilation
Chapter11NoninvasiveVentilation
Chapter12HumidificationandtheVentilatorCircuit
Chapter13FIO2,PositiveEnd-ExpiratoryPressure,andMeanAirway
Pressure
Chapter14InitialSettingsforMechanicalVentilation
Chapter15Patient-VentilatorAsynchrony
Chapter16VentilatorLiberation
Part2VentilatorManagement
Chapter17AcuteRespiratoryDistressSyndrome
Chapter18ObstructiveLungDisease
Chapter19ChestTrauma
Chapter20HeadInjury
Chapter21PostoperativeMechanicalVentilation
Chapter22NeuromuscularDisease
Chapter23CardiacFailure
Chapter24BurnsandInhalationInjury
Chapter25BronchopleuralFistula
Chapter26DrugOverdose
Part3MonitoringDuringMechanicalVentilation
Chapter27BloodGases
Chapter28PulseOximetry,Capnography,andTranscutaneousMonitoring
Chapter29HemodynamicMonitoring
Chapter30BasicPulmonaryMechanicsDuringMechanicalVentilation
Chapter31AdvancedPulmonaryMechanicsDuringMechanicalVentilation
Chapter32NutritionalAssessment
Part4TopicsRelatedtoMechanicalVentilation
Chapter33AirwayManagement
Chapter34AirwayClearance
Chapter35InhaledDrugDelivery
Chapter36EmergencyVentilationandVentilationinaDisaster
Chapter37MobilizationandPortableVentilation
Chapter38ExtracorporealLifeSupport
Index
Preface
Mechanicalventilationisanintegralpartofthecareofmanycriticallyill
patients.ItisalsoprovidedatsitesoutsidetheICUandoutsidethehospital,
includinglong-termacutecarehospitalsandthehome.Athorough
understandingoftheessentialsofmechanicalventilationisrequisitefor
respiratorytherapistsandcriticalcarephysicians.Ageneralknowledgeofthe
principlesofmechanicalventilationisalsorequiredofcriticalcarenursesand
primarycarephysicianswhosepatientsoccasionallyrequireventilatorysupport.
Thisbookisintendedtobeapracticalguidetoadultmechanicalventilation.
Wehavewrittenthisbookfromourperspectiveofover75yearsofexperience
asclinicians,educators,researchers,andauthors.Wehavemadeeveryattempt
tokeepthetopicscurrentandwithadistinctlyclinicalfocus.Asintheprevious
editions,wehavekeptthechaptersshort,focused,andpractical.
Therehavebeenmanyadvancesinthepracticeofmechanicalventilation
overthepast10years.Hence,muchofthebookisrewritten.Likeprevious
editions,thebookisdividedintofourparts.Part1,PrinciplesofMechanical
Ventilation,describesbasicprinciplesofmechanicalventilationandthen
continueswithissuessuchasindicationsformechanicalventilation,appropriate
physiologicgoals,andweaningfrommechanicalventilation.Part2,Ventilator
Management,givespracticaladviceforventilatingpatientswithavarietyof
diseases.Part3,MonitoringDuringMechanicalVentilation,discussesblood
gases,hemodynamics,mechanics,andwaveforms.Inthefinalpart,Topics
RelatedtoMechanicalVentilation,wediscussissuessuchasairway
management,aerosoldelivery,extracorporeallifesupport,andmiscellaneous
ventilatorytechniques.
Thisisabookaboutmechanicalventilationandnotmechanicalventilators.
Wedonotdescribetheoperationofanyspecificventilator(althoughwedo
discusssomemodesspecifictosomeventilatortypes).Wehavetriedtokeepthe
materialcoveredinthisbookgenericanditis,byandlarge,applicabletoany
adultmechanicalventilator.Wedonotcoverissuesrelatedtopediatricand
neonatalmechanicalventilation.Becausethesetopicsareadequatelycoveredin
pediatricandneonatalrespiratorycarebooks,wedecidedtolimitthefocusof
thisbooktoadultmechanicalventilation.Althoughweprovideashort
bibliographyattheendofeachchapter,wehavespecificallytriedtomakethisa
practicalbookandnotanextensivereferencebook.
Thisbookiswrittenforallclinicianscaringformechanicallyventilated
patients.Webelievethatitisuniqueandhopeyouwillenjoyreadingitasmuch
aswehaveenjoyedwritingit.
DeanR.Hess,PhD,RRT
RobertM.Kacmarek,PhD,RRT
Abbreviations
A/C
Assist/control
AG
Aniongap
APRV
Airwaypressurereleaseventilation
ARDS
Acuterespiratorydistresssyndrome
ARDSnet ARDSnetwork
AVAPS
Averagevolumeassuredpressuresupport
BAL
Bronchoalveolarlavage
BE
Baseexcess
BEE
Basalenergyexpenditure
BSA
Bodysurfacearea
CCI
Chroniccriticalillness
Cao2
Oxygencontentofarterialblood
CC′O2
Pulmonarycapillaryoxygencontent
CDC
CentersforDiseaseControlandPrevention
CI
Cardiacindex
CL
Lungcompliance
Cl–
Chlorideion
CMV
Continuousmandatoryventilation
CO
Carbonmonoxide
CO2
Oxygencontentoftheblood
COPD
Chronicobstructivepulmonarydisease
CPAP
Continuouspositiveairwaypressure
CPP
Cerebralperfusionpressure
CPR
Cardiopulmonaryresuscitation
CSV
Continuousspontaneousventilation
CT
Computedtomography
C
O2
Mixedvenousoxygencontent
CVP
Centralvenouspressure
CW
Chestwallcompliance
DO2
Oxygendelivery
EAdi
Electricalactivityofthediaphragm
ECLS
Extracorporeallifesupport
ECMO
Extracorporealmembraneoxygenation
EELV
End-expiratorylungvolume
EPAP
Expiratorypositiveairwaypressure
fb
Frequencyofbreathing;respiratoryrate
fc
Heartrate
FIO2
Fractionofinspiredoxygen
FRC
Functionalresidualcapacity
Hb
Hemoglobin
HbCO
Carboxyhemoglobin
HCO3–
Bicarbonateconcentration
HFJV
Highfrequencyjetventilation
HFOV
Highfrequencyoscillatoryventilation
HFPPV
Highfrequencypositivepressureventilation
HFV
Highfrequencyventilation
HME
Heatandmoistureexchanger
Hz
Hertz
I:E
Inspiratorytimetoexpiratorytimeratio
IBW
Idealbodyweight(sometimescalledpredictedbodyweight)
ICP
Intracranialpressure
ICU
Intensivecareunit
IMV
Intermittentmandatoryventilation
iNO
Inhalednitricoxide
IPAP
Inspiratorypositiveairwaypressure
ISB
Isothermalsaturationboundary
IVAC
Infectionrelatedventilatorassociatedcondition
j
Joules
LV
Leftventricle
LVSWI
Leftventricularstrokeworkindex
MAP
Meanarterialpressure
MDI
Metered-doseinhaler
MIC
Maximuminsufflationcapacity
MIE
Mechanicalinsufflation–exsufflator
MMV
Mandatoryminuteventilation
MODS
Multipleorgandysfunctionsyndrome
MPAP
Meanpulmonaryarterypressure
NO
Nitricoxide
Na+
Sodium
NAVA
Neurallyadjustedventilatoryassist
NIV
Noninvasiveventilation
NPE
Neurogenicpulmonaryedema
OI
Oxygenationindex
ΔPaw
Changeinairwaypressure
ΔPL
Transpulmonarypressure
ΔPOP
Plethysmographicwaveformamplitude
ΔPpl
Changeinpleuralpressure
P(a-
et)CO2
Differencebetweenarterialandend-tidalPco2
Pao2/PAO2 RatioofarterialPO2toalveolarPO2
Pao2/FIO2 RatioofarterialPo2toFIO2
P(A-a)o2 DifferencebetweenalveolarPo2andarterialPo2
Paco2
alv
Partialpressureofcarbondioxideinarterialblood
Meanalveolarpressure
Palv
Alveolarpressure
Pao2
Partialpressureofoxygeninarterialblood
PAO2
AlveolarPo2
PAP
Pulmonaryarterypressure
PAV
Proportional-assistventilation
aw
Meanairwaypressure
Pb
Barometricpressure
Pbo2
BrainPo2
PC-CMV Continuousmandatoryventilationwithpressurecontrol
PC-IMV
Pressure-controlledintermittentmandatoryventilation
PCIRV
Pressure-controlledinverserationventilation
PCO2
Partialpressureofcarbondioxide
PCV
Pressure-controlledventilation
PCWP
Pulmonarycapillarywedgepressure
Pdi
Transdiaphragmaticpressure
P
MixedexhaledPCO2
CO2
PH2O
Watervaporpressure
PEEP
Positiveend-expiratorypressure
PEG
Percutaneousendoscopicgastrostomy
Peso
Esophagealpressure
Petco2
End-tidalPCO2
Pexhco2
MeasuredmixedexhaledPCO2includinggascompressedinthe
ventilatorcircuit
pH
Negativelogofthehydrogenionconcentration
PI
Plethysmographicperfusionindex
PImax
Maximuminspiratorypressure
PImin
Minimalvalueoftheplethysmographicperfusionindex
PIP
Peakinspiratorypressure
Pmus
Pressuregeneratedbytherespiratorymuscles
PMV
Prolongedmechanicalventilation
PO2
Partialpressureofoxygen
Pplat
Plateaupressure
PPV
Arterialpulsepressurevariation
PRVC
Pressure-regulatedvolumecontrol
PSV
Pressuresupportventilation
Ptcco2
TranscutaneousPCO2
Ptco2
TranscutaneousPO2
P
MixedvenousPCO2
CO2
Pvent
Pressure-generatedbytheventilator
PVI
Plethysmographicvariabilityindex
P o2
MixedvenousPO2
PVR
Pulmonaryvascularresistance
c
Cardiacoutput
s/ T
Pulmonaryshunt
R
Respiratoryquotient
RE
Expiratoryresistance
REE
Restingenergyexpenditure
REM
Rapideyemovement
RI
Inspiratoryresistance
RSBI
Rapidshallowbreathingindex
RVSWI
Rightventricularstrokeworkindex
Sao2
Hemoglobinoxygensaturationofarterialblood
SBT
Spontaneousbreathingtrial
Scvo2
Centralvenousoxygensaturation
SID
Strongiondifference
SIMV
Synchronizedintermittentmandatoryventilation
Sjvo2
Jugularvenousoxygensaturation
Spco
Carbonmonoxidemeasuredbypulseoximetry
SpHb
Hemoglobinmeasuredbypulseoximetry
SpMet
Methemoglobinmeasuredbypulseoximetry
Spo2
Hemoglobinoxygensaturationmeasuredbypulseoximetry
SVI
Strokevolumeindex
S
Mixedvenousoxygensaturation
O2
SVR
Systemicvascularresistance
SVRI
Systemicvascularresistanceindex
TE
Expiratorytime
TI
Inspiratorytime
TT
Totalcycletime
UUN
Urineureanitrogen
Flow
A
Alveolarventilation
/
Ratioofventilationtobloodflow
VAC
Ventilator-associatedcondition
VAE
Ventilator-associatedevent
VAP
Ventilator-associatedpneumonia
VC
CO2
D
Vitalcapacity
Carbondioxideproduction
Deadspaceventilation
E
Minuteventilation
I
Inspiratoryflow
VCV
Volume-controlledventilation
VC-CMV Continuousmandatoryventilationwithvolumecontrol
VC-IMV volume-controlledintermittentmandatoryventilation
VD/VT
Deadspacetotidalvolumeratio
VILI
Ventilator-inducedlunginjury
O2
Oxygenconsumption
VS
Volumesupport
VT
Tidalvolume
W
Work
τ
Timeconstant
Part1
PrinciplesofMechanicalVentilation
Chapter1
PhysiologicEffectsofMechanicalVentilation
•Introduction
•MeanAirwayPressure
•PulmonaryEffects
Shunt
Ventilation
Atelectasis
Barotrauma
Ventilator-InducedLungInjury
Pneumonia
HyperventilationandHypoventilation
OxygenToxicity
•CardiacEffects
•RenalEffects
•GastricEffects
•NutritionalEffects
•NeurologicEffects
•NeuromuscularEffects
•HepatosplanchnicEffects
•AirwayEffects
•SleepEffects
•Patient-VentilatorAsynchrony
•MechanicalMalfunctions
•PointstoRemember
•AdditionalReading
