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Mechanical Ventilation from Pathophysiology to Clinical Evidence 2022 ed. [Hardback]

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  • Formāts: Hardback, 428 pages, height x width: 235x155 mm, weight: 922 g, 71 Illustrations, color; 15 Illustrations, black and white; XXII, 428 p. 86 illus., 71 illus. in color., 1 Hardback
  • Izdošanas datums: 17-Mar-2022
  • Izdevniecība: Springer Nature Switzerland AG
  • ISBN-10: 3030934004
  • ISBN-13: 9783030934002
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Mechanical Ventilation from Pathophysiology to Clinical Evidence 2022 ed.Palielināt
  • Formāts: Hardback, 428 pages, height x width: 235x155 mm, weight: 922 g, 71 Illustrations, color; 15 Illustrations, black and white; XXII, 428 p. 86 illus., 71 illus. in color., 1 Hardback
  • Izdošanas datums: 17-Mar-2022
  • Izdevniecība: Springer Nature Switzerland AG
  • ISBN-10: 3030934004
  • ISBN-13: 9783030934002
Citas grāmatas par šo tēmu:
Permanent link: https://www.kriso.lv/db/9783030934002.html
Keywords:
This book aims to give a comprehensive overview of the current challenges and solution posed to the health care professionals who need to use mechanical ventilation to treat their patients.

Mechanical ventilation is a cornerstone of the treatment of critically ill patients, as also dramatically underlined by the recent COVID-19 pandemic. The topic is not simple to approach, since it requires integration of multiple data which, in turn, result from complex interplays between patient’s condition and ventilatory settings. While technological development empowered advanced monitoring and decision support, these also increase the burden of data on the practitioners.

Furthermore, considering that sometimes mechanical ventilation is seen under two, apparently opposite, approaches, “physiology vs. protocols”, the book aims to reconcile these two aspects. And this has been done by each author following the above trajectory in their chapters.

The exposure of the topic begins from the “pathophysiology” (i.e. the “physiology of the disease”) so that the reader can better understand the concept and rationale of any given approach. At the same time, any rationale or hypothesis (for as much as supported by physiology) must hold at the proof of clinical research and evidence, which is summarized in each chapter.

In summary, the purposes is that the readers understand not only which is the best clinical practice to adopt but also why and which mechanisms this is based upon and how to approach a novel issue they might encounter. The book – addressed to physicians, nurses and respiratory therapist – features chapters on “novel” or “hot” topics like, obviously, COVID-19, ECMO, but also MV in low resource setting.

Part I Techniques
1 Basic Physiology of Respiratory System: Gas Exchange and Respiratory Mechanics
3(10)
Khoi Do
Guido Musch
1.1 Gas Exchange
3(4)
1.2 Respiratory Mechanics
7(5)
Reference
12(1)
2 A Short History of Mechanical Ventilation
13(8)
Philippe R. Bauer
2.1 Respiration, Circulation, and Their Interaction
13(1)
2.2 Oxygen, Combustion, Metabolism, Homeostasis
13(1)
2.3 The Dawn of Mechanical Ventilation
14(2)
2.4 Lessons Learned
16(3)
Reference
19(2)
3 Airway Management in the Critically Ill
21(16)
Sheila Nainan Myatra
3.1 Introduction
21(1)
3.2 Indications for Tracheal Intubation in ICU
22(1)
3.3 Planning and Preparation for Tracheal Intubation
23(1)
3.3.1 Clinical History and General Examination
23(1)
3.3.2 Airway Assessment
23(1)
3.3.3 Airway Cart and Checklists
23(1)
3.3.4 Team Preparation
24(1)
3.4 The Tracheal Intubation Procedure
24(7)
3.4.1 Patient Positioning
26(1)
3.4.2 Preoxygenation and Apnoeic Oxygenation
26(1)
3.4.3 Induction of Anaesthesia
27(1)
3.4.4 Controversies in Rapid Sequence Intubation
28(1)
3.4.5 Haemodynamic Support During Tracheal Intubation
29(1)
3.4.6 Device Selection for Tracheal Intubation
29(1)
3.4.7 Confirmation of Tracheal Tube Position
30(1)
3.5 Rescue Oxygenation
31(1)
3.6 Care and Maintenance of the Tracheal Tube
32(1)
3.7 Human Factors in Airway Management
32(1)
3.8 Future Research
32(1)
3.9 Conclusion
33(1)
Reference
33(4)
4 Controlled Mechanical Ventilation: Modes and Monitoring
37(12)
Eduardo L.V. Costa
Glauco M. Plens
Caio C.A. Morais
4.1 Pressure-Controlled Ventilation
39(1)
4.2 Volume-Controlled Ventilation
39(1)
4.3 Pressure-Regulated Volume-Guaranteed Ventilation
40(1)
4.4 Physiological Features of Fully Controlled Modes
40(1)
4.4.1 Lung Protection
40(1)
4.4.2 Alveolar Ventilation
41(1)
4.5 Modes Particularities During Inspiratory Effort
41(1)
4.6 Monitoring During Controlled Ventilation
42(5)
4.6.1 Static Measurements of Inspiratory Resistance and Respiratory Compliance
44(1)
4.6.2 Low-Flow Pressure-Volume (P-V) Curves
44(2)
4.6.3 Stress Index
46(1)
4.7 Conclusion
47(1)
Reference
48(1)
5 Assisted Ventilation: Pressure Support and Bilevel Ventilation Modes
49(12)
Irene Telias
Annemijn Jonkman
Nuttapol Rittayamai
5.1 Introduction
49(1)
5.2 Pressure Support Ventilation
50(4)
5.2.1 Epidemiology, Potential Advantages and Disadvantages
50(1)
5.2.2 Principles of Operation and Physiological Consequences of PSV
50(2)
5.2.3 Potentially Injurious Patient-Ventilator Interactions During Pressure Support Ventilation
52(2)
5.2.4 How to Set the Level of Support to Prevent Over and Under-Assistance
54(1)
5.3 Bilevel Ventilation Modes
54(3)
5.3.1 Bilevel Vs. Other Pressure-Controlled Modes
54(2)
5.3.2 Physiologic Effects of Differences in Inspiratory Synchronization
56(1)
5.3.3 Setting Bilevel Ventilation During Assisted Mechanical Ventilation
56(1)
5.3.4 Clinical Evidence of Bilevel Vs. Conventional Modes During Assisted Mechanical Ventilation
57(1)
5.4 Conclusion
57(1)
Reference
58(3)
6 Monitoring the Patient During Assisted Ventilation
61(14)
Alice Grassi
Irene Telias
Giacomo Bellani
6.1 Inspiratory Effort
62(4)
6.1.1 Esophageal Pressure Derived Measurements
62(1)
6.1.2 Tidal Volume and Respiratory Rate
63(1)
6.1.3 p0.1
64(1)
6.1.4 Occlusion Pressure
64(1)
6.1.5 Pressure Muscle Index
65(1)
6.1.6 Diaphragm Electrical Activity
65(1)
6.2 Total Pressure Distending the Respiratory System
66(2)
6.3 Asynchronies
68(1)
6.4 Distribution of Ventilation and Pendelluft
69(1)
6.5 Evaluation of Respiratory Muscles Activity by Ultrasound
70(1)
6.6 Conclusion
70(1)
Reference
70(5)
7 Neurally Adjusted Ventilatory Assist
75(10)
Hadrien Roze
7.1 Working Principles
75(2)
7.1.1 EAdi Signal
75(1)
7.1.2 NAVA Mode
76(1)
7.2 How to Set Ventilatory Assistance During NAVA
77(3)
7.2.1 Airway Pressure Targets
77(1)
7.2.2 Tidal Volume Response to NAVAlevel Titration
78(1)
7.2.3 EAdi Response to NAVAievei Titration
79(1)
7.2.4 Neuro-Ventilatory Efficiency (NVE)
79(1)
7.2.5 EAdi Derived Indices with NAVA
79(1)
7.3 How to Set PEEP Under NAVA
80(1)
7.4 How to Wean NAVA
80(1)
7.5 Clinical Effects of NAVA
81(1)
7.5.1 Effect on VT
81(1)
7.5.2 Effects on Asynchrony
81(1)
7.5.3 NAVA During Non-Invasive Ventilation or Tracheostomy
82(1)
7.6 Limitation of NAVA
82(1)
7.7 Conclusion
82(1)
Reference
83(2)
8 Proportional Assist Ventilation
85(8)
Eumorfia Kondili
Evangelia Akoumianaki
8.1 Introduction
85(1)
8.2 Operation Principles
85(3)
8.3 Advantages of PAV+
88(2)
8.3.1 Protection from Over- or Under-Assistance
88(1)
8.3.2 Breathing Pattern and Patient-Ventilator Interaction
89(1)
8.3.3 Clinical Outcomes
90(1)
8.4 Limitations in PAV/PAV+ Use
90(1)
8.5 Titration of Assistance in PAV+
90(1)
8.6 Conclusion
91(1)
Reference
91(2)
9 Non-Invasive Ventilation: Indications and Caveats
93(12)
Oriol Roca
Domenico Luca Grieco
Laveena Munshi
9.1 Introduction
93(1)
9.2 NIV Interfaces
94(1)
9.3 Mode of Ventilation
95(1)
9.4 Physiological Effects of NIV
95(1)
9.5 Indications for NIV
96(3)
9.5.1 Hydrostatic Pulmonary Edema
96(1)
9.5.2 Hypercapnic Respiratory Failure: Acute Exacerbation of COPD
97(1)
9.5.3 De-Novo Acute Hypoxemic Respiratory Failure
97(1)
9.5.4 Immunocompromised Patients
98(1)
9.5.5 Pre-Oxygenation
98(1)
9.5.6 After Invasive Mechanical Ventilation
99(1)
9.5.7 Insufficient Data
99(1)
9.6 The Importance of Monitoring of Patient with NIV
99(2)
9.6.1 Monitoring the Patient with NIV
99(2)
9.7 Conclusions
101(1)
Reference
102(3)
10 High Flow Nasal Oxygen: From Physiology to Clinical Practice
105(10)
Sharon Einav
Marta Velia Antonini
10.1 Introduction
105(1)
10.2 Dead Space, Air Entrainment, and Washout
106(1)
10.2.1 The Way Forward
107(1)
10.3 Generation of PEEP (or Not)
107(1)
10.3.1 The Way Forward
107(1)
10.4 Work of Breathing (WOB)
108(2)
10.4.1 Work of Breathing in Normal Adults and in Hypoxemic Respiratory Failure
108(1)
10.4.2 Work of Breathing in Patients with Decompensated Chronic Obstructive Pulmonary Disease (COPD)
109(1)
10.4.3 The Way Forward
110(1)
10.5 Some Words of Caution
110(1)
10.6 Conclusion
111(1)
Reference
111(4)
11 Nursing of Mechanically Ventilated and ECMO Patient
115(12)
Marta Velia Antonini
Johannes Mellinghoff
11.1 Mechanical Ventilation
116(2)
11.2 Prone Position
118(2)
11.3 ECMO
120(4)
11.4 Conclusions
124(1)
Reference
124(3)
12 Closed-Loop Ventilation Modes
127(12)
Jean-Michel Arnal
Dirk Schaedler
Cenk Kirakli
12.1 Introduction
127(1)
12.2 Mandatory Minute Ventilation
128(1)
12.3 Smartcare/PS
128(2)
12.3.1 Principle of Operation
128(1)
12.3.2 Monitoring
129(1)
12.3.3 Evidence
130(1)
12.4 Adaptive Support Ventilation
130(3)
12.4.1 Principle of Operation
130(2)
12.4.2 Settings and Monitoring
132(1)
12.4.3 Weaning
132(1)
12.4.4 Evidence
132(1)
12.5 INTELLiVENT-ASV
133(2)
12.5.1 Principle of Operation
133(1)
12.5.2 Settings and Monitoring
133(1)
12.5.3 Weaning
134(1)
12.5.4 Evidence
135(1)
12.6 Conclusion
135(1)
Reference
135(4)
13 Airway Pressure Release Ventilation
139(10)
Niklas Larsson
13.1 Introduction
139(1)
13.2 Physiology
140(1)
13.3 Indications
140(1)
13.4 Settings
141(2)
13.4.1 PHigh
141(1)
13.4.2 THigh
142(1)
13.4.3 PLow
142(1)
13.4.4 TLow
143(1)
13.5 Spontaneous Breathing
143(1)
13.6 Weaning
144(1)
13.7 Conclusion
144(1)
Reference
145(4)
Part II Clinical Scenarios
14 Acute Hypoxaemic Respiratory Failure and Acute Respiratory Distress Syndrome
149(16)
Bairbre McNicholas
Emanuele Rezoagli
John G. Laffey
14.1 AHRF and ARDS: A Definition Problem
149(5)
14.2 Epidemiology: Knowns and Unknowns
154(1)
14.3 Pathophysiology: Insights and Gaps
155(1)
14.4 Support of Gas Exchange
155(1)
14.5 Invasive Mechanical Ventilation: From 'Protective' to 'Personalized'
156(1)
14.6 Adjuncts to Ventilation
157(1)
14.7 Specific Therapies for ARDS and AHRF
158(1)
14.8 Outcomes
158(1)
14.9 AHRF: Changing the Paradigm
159(1)
14.10 Conclusions
160(1)
Reference
160(5)
15 Ventilator-Induced Lung Injury and Lung Protective Ventilation
165(12)
Guillermo M. Albaiceta
Laura Amado-Rodriguez
15.1 Mechanosensitivity of the Respiratory System
166(1)
15.2 Pathophysiology of Ventilator-Induced Lung Injury
167(2)
15.3 Bedside Assessment of VILI
169(1)
15.4 Designing Lung Protective Strategies
170(3)
15.5 Clinical Evidence on Protective Ventilation
173(1)
15.6 Conclusion
174(1)
Reference
174(3)
16 Mechanical Ventilation in the Healthy Lung: OR and ICU
177(10)
Fabienne D. Simonis
Frederique Paulus
Marcus J. Schultz
16.1 Introduction
177(1)
16.2 Tidal Volume
178(1)
16.3 Tidal Volume in the Operating Room
178(1)
16.3.1 Benefit of a Lower VT
178(1)
16.3.2 Challenges of a Lower VT
179(1)
16.3.3 Temporal Changes in the Size of VT
179(1)
16.3.4 Current Recommendations
179(1)
16.4 Tidal Volume the Intensive Care Unit
179(2)
16.4.1 Benefit of a Lower VT
179(1)
16.4.2 Challenges of a Lower VT
180(1)
16.4.3 Temporal Changes in the Size of VT
180(1)
16.4.4 Current Recommendations
180(1)
16.5 Positive End-Expiratory Pressure
181(1)
16.6 PEEP in the Operating Room
181(1)
16.6.1 Benefit of Higher PEEP
181(1)
16.6.2 Challenges of Higher PEEP
182(1)
16.6.3 Temporal Changes in PEEP
182(1)
16.6.4 Current Recommendations
182(1)
16.7 PEEP in the Intensive Care Unit
182(2)
16.7.1 Benefit of Higher PEEP
182(1)
16.7.2 Challenges of Higher PEEP
183(1)
16.7.3 Temporal Changes in PEEP
183(1)
16.7.4 Current Recommendations
183(1)
16.8 Conclusions
184(1)
Reference
184(3)
17 PEEP Setting in ARDS
187(12)
Emanuele Rezoagli
Giacomo Bellani
17.1 Introduction
187(1)
17.2 Pathophysiology: Beneficial Effects of PEEP
188(1)
17.3 Pathophysiology: Harmful Effects of PEEP
188(1)
17.4 Recommendations of PEEP Setting in ARDS
189(1)
17.5 Strategies Aimed at Titrating PEEP at Bedside
189(5)
17.5.1 NIH PEEP/FiO2 Combination Tables
189(1)
17.5.2 Respiratory Mechanics: Compliance and Driving Pressure of the Respiratory System (Cpl,rs)
190(1)
17.5.3 Pressure-Volume (PV) Curve and Lung Volume Measurements
191(1)
17.5.4 Stress Index (SI)
191(1)
17.5.5 Transpulmonary Pressure
192(1)
17.5.6 Lung Imaging
192(2)
17.5.7 PEEP: The Role of ARDS Phenotypes
194(1)
17.6 Conclusion
194(1)
Reference
194(5)
18 Mechanical Ventilation in Brain Injured Patients
199(6)
Lorenzo Peluso
Elisa Bogossian
Chiara Robba
18.1 Introduction
199(1)
18.2 Indications for Invasive Mechanical Ventilation in Brain Injured Patients
199(1)
18.3 Ventilatory Strategies and Targets
200(2)
18.3.1 Ventilator Settings
200(1)
18.3.2 Oxygenation and Carbon Dioxide Targets
200(2)
18.4 Rescue Interventions for Refractory Respiratory Failure
202(1)
18.5 Weaning and Tracheostomy
202(1)
18.6 Ventilation in Neuromuscular Disease
203(1)
18.7 Conclusions
203(1)
Reference
204(1)
19 Invasive and Non-invasive Ventilation in Patient with Cardiac Failure
205(10)
Aurora Magliocca
Giuseppe Ristagno
19.1 Introduction
205(1)
19.2 Pathophysiology of Respiratory Failure During Acute Cardiac Failure
205(1)
19.2.1 Acute Cardiogenic Pulmonary Edema
205(1)
19.2.2 Cardiogenic Shock
206(1)
19.3 Rationale for Positive Airway Pressure in Patients with Cardiac Failure
206(3)
19.3.1 Right Ventricle
207(1)
19.3.2 Left Ventricle
208(1)
19.4 Non-invasive Positive Pressure Ventilation for Cardiogenic Pulmonary Edema: Clinical Evidence
209(1)
19.5 Non-invasive and Invasive Positive Pressure Ventilation for Cardiogenic Shock
210(1)
19.6 Ventilation in the Post Cardiac Arrest Period
210(1)
Reference
211(4)
20 COPD and Severe Asthma
215(8)
Lise Piquilloud
Damian Ratano
20.1 Pathophysiology
215(1)
20.2 Respiratory Support Strategies in General
216(2)
20.3 Controlled Invasive Ventilation of the Obstructive Patient: Goals, Monitoring of Dynamic Airtrapping and Settings Strategies
218(2)
20.4 Assisted Invasive Ventilation of the Obstructive Patient and Weaning Strategy
220(1)
Reference
221(2)
21 Ventilation in the Obese Patient
223(8)
Pedro Leme Silva
Paolo Pelosi
Patricia Rieken Macedo Rocco
21.1 Introduction
223(1)
21.2 Input Ventilatory Parameters to Be Adjusted During Mechanical Ventilation in Obese Patients
224(2)
21.2.1 Tidal Volume
224(1)
21.2.2 Positive End-Expiratory Pressure
225(1)
21.2.3 Recruitment Maneuvers
225(1)
21.3 Output Ventilatory Parameters to Be Monitored During Mechanical Ventilation in Obese Patients
226(2)
21.3.1 Driving Pressure
226(1)
21.3.2 Plateau Pressure
226(2)
21.3.3 Energy and Mechanical Power
228(1)
21.4 Conclusion
228(1)
Reference
229(2)
22 Weaning the Simple and Complex Patients
231(14)
Tai Pham
Martin Dres
Remit Coudroy
22.1 Introduction
231(1)
22.2 Weaning Definitions and Steps
232(4)
22.2.1 What Is Weaning, When Does Is Start? (and When Does It End???)
232(2)
22.2.2 Are There Simple and Complex Patients?
234(1)
22.2.3 During the Acute Phase
235(1)
22.2.4 After the Illness Acute Phase
235(1)
22.3 The Separation Attempt Process
236(3)
22.3.1 Challenges and Pitfalls
236(1)
22.3.2 Which Spontaneous Breathing Trial?
237(1)
22.3.3 Pathophysiology of Spontaneous Breathing Trial Failure
238(1)
22.4 Preventing Extubation Failure
239(3)
22.4.1 Complications Following Extubation: Epidemiology and Definitions
239(1)
22.4.2 Risk Factors of Extubation Failure
240(1)
22.4.3 Strategies Aiming at Preventing Extubation Failure
240(1)
22.4.4 Summary of the Evidence Regarding the Efficacy of Strategies Aiming at Preventing Extubation Failure in the ICU
241(1)
22.4.5 Treatment of Post-Extubation Respiratory Failure
241(1)
22.5 Conclusion
242(1)
Reference
242(3)
23 Non-invasive Oxygenation Strategies for COVID-19 Related Respiratory Failure
245(10)
Michael C. Sklar
Bhakti K. Patel
Laveena Munshi
23.1 Introduction
245(1)
23.2 Non-invasive Oxygen Strategies: Devices, Physiology and Non-COVID-19 Evidence
246(2)
23.2.1 Devices and Physiology
246(2)
23.3 Considerations for Non-invasive Oxygenation Strategies in the COVID-19 Pandemic
248(4)
23.3.1 Caring for Critically-Ill Patients Outside of the Intensive Care Unit
249(1)
23.3.2 The Risk of Aerosolization
249(1)
23.3.3 Interhospital Transport
250(1)
23.3.4 Evidence for Non-invasive Oxygenation Supports in COVID-19
251(1)
23.3.5 Patient Positioning
251(1)
23.4 Conclusion
252(1)
Reference
252(3)
24 Invasive Ventilation in COVID-19
255(10)
Giacomo Grasselli
Gaetano Florio
Emanuele Cattaneo
24.1 Introduction
255(1)
24.2 Endotracheal Intubation and Timing
256(1)
24.3 Mechanical Ventilation Setting
256(4)
24.4 Rescue Therapies
260(1)
24.5 Tracheostomy
261(1)
24.6 Conclusions
262(1)
Reference
262(3)
25 Mechanical Ventilation in Different Surgical Settings
265(14)
Luigi Zattera
Adriana Jacas
Carlos Ferrando
25.1 Introduction
265(5)
25.1.1 Postoperative Pulmonary Complications
265(1)
25.1.2 Protective Mechanical Ventilation: Basic Concepts
266(1)
25.1.3 Personalized PEEP: The Open Lung Approach (OLA)
267(3)
25.2 Laparoscopic Surgery
270(1)
25.2.1 Current Evidence
270(1)
25.3 Obese Patients
270(1)
25.3.1 Current Evidence
271(1)
25.4 Thoracic Surgery
271(1)
25.4.1 Current Evidence
272(1)
25.5 Cardiac Surgery
272(1)
25.5.1 Current Evidence
272(1)
25.6 Neurosurgery
273(1)
25.6.1 Current Evidence
274(1)
25.7 Conclusions
274(1)
Reference
275(4)
26 Following Up the Patients at Long Term
279(10)
Nicola Latronico
Simone Piva
Frank Rasulo
26.1 Introduction
279(1)
26.1.1 A Logistic and Cultural Framework to Assist ICU Survivors
280(1)
26.2 The Follow-Up Clinic and the PICS Framework
280(6)
26.2.1 Physical Impairment
282(1)
26.2.2 Cognitive Impairment
283(1)
26.2.3 Mental Health Impairment
284(2)
26.3 Conclusions
286(1)
Reference
286(3)
27 Mechanical Ventilation in Limited Resource Settings
289(8)
Theogene Twagirumugabe
27.1 Introduction
289(1)
27.2 Facilities for Mechanical Ventilation in Limited Resource Settings
290(1)
27.3 Indications of Mechanical Ventilation in Resource Variable Settings
290(1)
27.4 Modes of Mechanical Ventilation in Limited Resource Settings
291(1)
27.5 Complications of Mechanical Ventilation in Limited Resource Settings
292(1)
27.6 The Practice of Tracheostomy in Patients with Prolonged Mechanical Ventilation
293(1)
27.7 Conclusion
293(1)
Reference
294(3)
28 Mechanical Ventilation During Patient's Transferral
297(10)
Susan Wilcox
Raymond Che
28.1 Overview
297(1)
28.2 How Transport Changes Physiology
297(1)
28.3 Setting the Ventilator for Transport
298(1)
28.4 Pulmonary and Airway Complications
299(1)
28.5 Cardiovascular Complications
300(1)
28.6 Equipment Malfunction, Considerations, and Human Error
300(1)
28.7 Importance of Checklists
301(2)
28.8 Conclusion
303(1)
Reference
303(4)
Part III Adjuncts to Mechanical Ventilation
29 Prone Position
307(10)
Claude Guerin
29.1 Rationale
307(3)
29.1.1 Effects on Oxygenation
307(1)
29.1.2 VILI Prevention
308(1)
29.1.3 Hemodynamics Effects
309(1)
29.2 Timing of Proning Application
310(1)
29.2.1 PaO2/F1O2 Threshold to Initiate Proning in ARDS
310(1)
29.2.2 When to Start Proning
310(1)
29.2.3 When to Stop Proning
311(1)
29.2.4 Duration of Proning Sessions
311(1)
29.3 Practical Issues
311(2)
29.3.1 Patient Installation
311(1)
29.3.2 Support of Abdomen
312(1)
29.3.3 Sedation and Neuromuscular Blockade During Prone Position
312(1)
29.3.4 Setting the Ventilator in Prone Position
312(1)
29.3.5 Contraindications
312(1)
29.4 Clinical Evidence
313(1)
29.4.1 Effects of Survival in Intubated Patients with Classic ARDS
313(1)
29.4.2 Findings in the COVID-19
313(1)
29.5 Conclusions
314(1)
Reference
314(3)
30 Veno-Venous ECMO and ECCO2R
317(10)
Marco Giani
Christophe Guervilly
Giuseppe Foti
30.1 Pathophysiology of Severe Respiratory Failure: Pulmonary Shunt and Alveolar Dead Space
317(1)
30.2 Why Extracorporeal Gas Exchange?
318(2)
30.3 "Full" V-V ECMO Versus Low-Flow ECCO2R
320(1)
30.4 Evidence for Extracorporeal Gas Exchange in ARDS Patients
321(1)
30.5 Outcome of ARDS Patients Treated with V-V ECMO
322(1)
30.6 Should the Number of ECMO Centers Be Increased?
322(1)
30.7 Conclusions
323(1)
Reference
323(4)
31 Mechanical Ventilation Setting During ECMO
327(14)
Luigi Camporota
Eddy Fan
31.1 Introduction
327(8)
31.1.1 Mechanical Ventilation Strategy in ARDS
327(1)
31.1.2 Mechanical Ventilation Strategy in Severe ARDS Receiving ECMO
328(1)
31.1.3 Effects of ECMO on Gas Exchange and Interactions with Native Lung Function
328(1)
31.1.4 Interaction Between the Native and the Artificial Lung
329(1)
31.1.5 Mechanical Ventilation on ECMO: General Principles
330(3)
31.1.6 Mechanical Ventilation Setting on ECMO
333(1)
31.1.7 Additional Considerations
334(1)
31.2 Conclusion
335(1)
Reference
335(6)
Part IV Monitoring of Mechanical Ventilation
32 Ultrasound Assessment of the Respiratory System
341(12)
Mark E. Haaksma
Marry R. Smit
Pieter R. Tuinman
32.1 Introduction
341(1)
32.2 The Lungs
342(4)
32.2.1 Introduction
342(1)
32.2.2 Application in Clinical Practice
343(3)
32.3 Diaphragm
346(4)
32.3.1 Introduction
346(2)
32.3.2 Application in Clinical Practice
348(2)
32.4 Accessory Respiratory Muscles
350(1)
32.5 Limitations
350(1)
32.6 Conclusion
350(1)
Reference
351(2)
33 Electrical Impedance Tomography
353(12)
Inez Frerichs
33.1 Introduction
353(1)
33.2 EIT Basics
354(2)
33.3 Patient Examination Using EIT
356(1)
33.4 Assessment of Regional Lung Ventilation and Aeration Changes by EIT
357(4)
33.5 Assessment of Regional Lung Perfusion by EIT
361(1)
33.6 Summary
361(1)
Reference
362(3)
34 Esophageal Pressure Monitoring
365(12)
Evangelia Akoumianaki
Katerina Vaporidi
34.1 Technique
365(2)
34.2 Measurements of Pes-derived Variables
367(4)
34.2.1 Transpulmonary Pressures
367(2)
34.2.2 Indices of Inspiratory Effort and Dynamic Hyperinflation
369(2)
34.3 Monitoring Esophageal Pressure to Guide Mechanical Ventilation
371(4)
34.3.1 Monitoring PL,end-exp for PEEP Titration to Prevent Alveolar Collapse
371(1)
34.3.2 Monitoring PL,end-insp and ΔPL for Tidal Volume/Inspiratory Pressure Titration to Prevent Overdistention
371(1)
34.3.3 Monitoring Spontaneous Effort to Prevent Over- and Under-Assist and Optimize Patient-Ventilator Interaction
372(3)
34.4 Conclusion
375(1)
Reference
375(2)
35 Lung Volumes and Volumetric Capnography
377(10)
Hong-liang Li
Jian-Xin Zhou
Lu Chen
35.1 Introduction
377(1)
35.2 Lung Volumes
378(4)
35.2.1 Why Is Measuring Absolute Lung Volume Clinically Relevant?
378(1)
35.2.2 How Are Absolute Lung Volumes Measured?
378(1)
35.2.3 How Are the Changes in Lung Volume Measured?
378(1)
35.2.4 How Is Recruitment Measured Using Computed Tomography?
379(1)
35.2.5 How Is Recruitment Measured Using Pressure-Volume Curves?
380(1)
35.2.6 How Is the Recruitment-to-Inflation Ratio Measured?
380(2)
35.3 Volumetric Capnography
382(3)
35.3.1 What Is Dead Space?
382(1)
35.3.2 How Is Dead Space Calculated?
382(1)
35.3.3 What Is Capnography?
383(1)
35.3.4 What Is a Capnometer?
383(1)
35.3.5 How Is Dead Space Measured Using Volumetric Capnography?
383(2)
35.3.6 What Are the Clinical Implications?
385(1)
Reference
385(2)
36 Radiological Monitoring
387(10)
Jean-Michel Constantin
Elodie Baron
Bao Long Nguyen
36.1 Introduction
387(1)
36.2 What Could We Expect from Chest X Ray in ICU?
388(2)
36.2.1 Assessing Lung Oedema
388(1)
36.2.2 Positioning of Monitor and/or Therapeutics Devices
389(1)
36.2.3 Pleural Effusions
390(1)
36.2.4 Pneumonia
390(1)
36.3 When is CT Scan Indicated in Ventilated Patients?
390(2)
36.4 Conclusions
392(1)
Reference
392(5)
Part V Educational Material
37 Teaching Mechanical Ventilation: Online Resources and Simulation
397(8)
Thomas Piraino
37.1 Introduction
397(1)
37.2 Online Resources and Applications
397(1)
37.2.1 Standardized Education for Ventilatory Assistance (SEVA)
)397
37.2.2 iVentilate App
398(1)
37.2.3 The Toronto Centre of Excellence in Mechanical Ventilation (CoEMV Blog)
398(1)
37.3 Mechanical Ventilation Simulation
398(5)
37.3.1 Software Simulation Options
399(2)
37.3.2 Hardware Simulation Options
401(1)
37.3.3 Setting Up a Successful Simulation Teaching Event
401(2)
37.4 Summary
403(2)
38 Vignettes: Controlled Mechanical Ventilation
405(12)
Matteo Pozzi
Giacomo Bellani
Emanuele Rezoagli
38.1 Introduction
405(1)
38.2 Clinical Vignettes
405(9)
Reference
414(3)
39 Vignettes: Assisted Mechanical Ventilation
417
Matteo Pozzi
Giacomo Bellani
Emanuele Rezoagli
39.1 Introduction
417(11)
Reference
428
Dr. Giacomo Bellani is Associate Professor of Anesthesia and Critical Care Medicine of the University of Milan-Bicocca, in Monza, Italy and staff physician in the general Intensive Care Unit of San Gerardo Hospital, where he completed the postgraduate training program in Anesthesia and Critical Care. In 2003-2004 he was research fellow at Massachusetts General Hospital, in Boston, MA. In 2006 he received the ESICM Young investigator award. In 2010 he acquired a PhD in Biomedical technology at UNIMIB. Research has always been complementary to his clinical activities. His research is largely focused on ARDS and mechanical ventilation monitoring. From October 2015 to October 2018 he was chairman of the Acute Respiratory Failure Section of ESICM. He is co-PI of the LUNG SAFE study (main manuscript published in 2016 on JAMA). He has participated to organization of several meetings and courses on mechanical ventilation.  He authored about 170 peer-reviewed papers, mainly focused on invasive and non-invasive ventilation, 10 book chapters, two patents delivering about 120 invited talks. He is co-founder and president of Reviewer Credits, co-founder of DICO Technologies.