A Practical Guide to Mechanical Ventilation - …

1 A Practical Guide to Mechanical VentilationA Practical Guide to Mechanical Ventilation , First by Jonathon D. Truwit and Scott K. Epstein. 2011 John Wiley & Sons, Ltd. Published 2011 by John Wiley & Sons, Ltd. ISBN: 978-0-470-05807-7 A Practical Guide to Mechanical VentilationEdited by Jonathon D. Truwit and Scott K. EpsteinA John Wiley & Sons, Ltd., PublicationThis edition fi rst published 2011, 2011 by John Wiley & Sons, LtdWiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley s global Scientifi c, Technical and Medical business with Blackwell offi ce: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UKEditorial Offi ces.

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3 All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be contents of this work are intended to further general scientifi c research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specifi c method, diagnosis, or treatment by physicians for any particular patient.

4 The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifi cally disclaim all warranties, including without limitation any implied warranties of fi tness for a particular purpose. In view of ongoing research, equipment modifi cations, changes in governmental regulations, and the constant fl ow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions.

5 Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising of Congress Cataloguing-in-Publication DataA Practical Guide to Mechanical Ventilation / edited by Jonathon D.

6 Truwit and Scott K. Epstein. p. ; cm. Includes index. ISBN 978-0-470-05807-7 (pbk.) 1. Artifi cial respiration Handbooks, manuals, etc. I. Truwit, Jonathon D. II. Epstein, Scott K. [DNLM: 1. Respiration, Artifi cial methods. 2. Respiratory Tract Diseases therapy. 3. Ventilator Weaning methods. 4. Ventilators, Mechanical . WF 145] 2011 '36 dc22 2010037010A catalogue record for this book is available from the British Library. This book is published in the following electronic formats: ePDFs: 978-0-470-97659-3; Wiley Online Library: 978-0-470-97660-9; ePub: 978-0-470-97664-7 Set in on pt Times by Toppan Best-set Premedia LimitedFirst Impression 2011 ContentsContributors ixPart I Noninvasive Ventilation Introduction to noninvasive Ventilation 3 Daniel C.

7 Grinnan and Jonathon D. Physiology of noninvasive Ventilation 17 Daniel C. Grinnan and Jonathon D. Noninvasive Ventilation in acute respiratory failure from COPD 31 Daniel C. Grinnan and Jonathon D. Noninvasive Ventilation in acute CHF 41 Daniel C. Grinnan and Jonathon D. Noninvasive Ventilation in acute respiratory failure 51 Daniel C. Grinnan and Jonathon D. Noninvasive Ventilation in chronic respiratory failure associated with COPD 63 Daniel C. Grinnan and Jonathon D. Noninvasive Ventilation in chronic respiratory disease 71 Daniel C. Grinnan and Jonathon D.

8 Weaning from invasive Ventilation to noninvasive Ventilation 83 Daniel C. Grinnan and Jonathon D. TruwitPart II Invasive Mechanical Ventilation Respiratory failure 95 Kyle B. Enfi eld and Jonathon D. Truwitvi Airway management Bag-Valve-Mask (BVM) assisted Ventilation 103 Drew A. Endotracheal intubation 108 Drew A. Cuff leak and laryngeal edema 117 Scott van Poppel and Drew A. The diffi cult airway 120 Jonathon D. Cricothyroidotomy 126 Mark R. Ventilator mechanics 133 David L.

9 Bowton and R. Duncan Modes of Mechanical Ventilation 141R. Duncan Assessing lung physiology 163 Daniel C. Grinnan and Jonathon D. Mechanical Ventilation in restrictive lung disease 173R. Duncan Mechanical Ventilation in obstructive lung disease 195 Rodolfo M. Pascual and Jeremy S. Ancillary methods to Mechanical Ventilation 205 Kyle B. Enfi eld and Jonathon D. Mechanical ventilator outcomes 215 Ali S. Wahla and Edward F. HaponikPart III Discontinuation from Mechanical Ventilation Defi nitions 241 Scott K. Readiness testing and weaning predictors 249 Scott K.

10 Physiological barriers 263 Scott K. Epstein Modes used during discontinuation 277 Scott K. Extubation 289 Scott K. Adjuncts to facilitate weaning 305 Scott K. Epstein and Marjolein de Wit CONTENTS Tracheostomy 319 Scott K. Putting it all together: protocols and algorithms 329 Scott K. Epstein and Maged A. TaniosIndex 339 Contributors Mark R. Bowling, MD Assistant professor of medicine Division of Pulmonary, Critical Care, and Sleep Medicine University of Mississippi Jackson, MS, USA David L.