Libros sobre el tema "Non invasive positive pressure ventilation"

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1

Christine, Mikelsons, ed. Non-invasive respiratory support techniques: Oxygen therapy, non-invasive ventilation, and CPAP. Chichester, West Sussex: Wiley-Blackwell, 2008.

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2

Rafferty, Mary Sara. A structural description of the experiences of individuals with severe Chronic Obstructive Pulmonary Disease using domiciliary non-invasive positive pressure ventilation. (s.l: The Author), 2001.

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3

Spoletini, Giulia y Nicholas S. Hill. Non-invasive positive-pressure ventilation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0090.

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Non-invasive ventilation (NIV) has been increasingly used over the past decades to avoid endotracheal intubation (ETI) in critical care settings. In selected patients with acute respiratory failure, NIV improves the overall clinical status more rapidly than standard oxygen therapy, avoids ETI and its complications, reduces length of hospital stay, and improves survival. NIV is primarily indicated in respiratory failure due to acute exacerbations of chronic obstructive pulmonary disease, cardiogenic pulmonary oedema and associated with immunocompromised states. Weaker evidence supports its use in other forms of acute hypercapnic and hypoxaemic respiratory failure. Candidates for NIV should be carefully selected taking into consideration the risk factors for NIV failure. Patients on NIV who are unstable or have risk factors for NIV failure should be monitored in an intensive or intermediate care units by experienced personnel to avoid delay when intubation is needed. Stable NIV patients can be monitored on regular wards.
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4

Masip, Josep, Kenneth Planas y Arantxa Mas. Non-invasive ventilation. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0025.

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During the last 25 years, the use of non-invasive ventilation has grown substantially. Non-invasive ventilation refers to the delivery of positive pressure to the lungs without endotracheal intubation and plays a significant role in the treatment of patients with acute respiratory failure and in the domiciliary management of some chronic respiratory and sleep disorders. In the intensive and acute care setting, the primary aim of non-invasive ventilation is to avoid intubation, and it is mainly used in patients with chronic obstructive pulmonary disease exacerbations, acute cardiogenic pulmonary oedema, or in the context of weaning, situations in which a reduction in mortality has been demonstrated. The principal techniques are continuous positive airway pressure and bilevel pressure support ventilation. Whereas non-invasive pressure support ventilation requires a ventilator, continuous positive airway pressure is a simpler technique that can be easily used in non-equipped areas such as the pre-hospital setting. The success of non-invasive ventilation is related to the adequate timing and selection of patients, as well as the appropriate use of interfaces, the synchrony of patient-ventilator, and the fine-tuning of the ventilator.
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5

Masip, Josep, Kenneth Planas y Arantxa Mas. Non-invasive ventilation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0025_update_001.

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During the last 25 years, the use of non-invasive ventilation has grown substantially. Non-invasive ventilation refers to the delivery of positive pressure to the lungs without endotracheal intubation and plays a significant role in the treatment of patients with acute respiratory failure and in the domiciliary management of some chronic respiratory and sleep disorders. In the intensive and acute care setting, the primary aim of non-invasive ventilation is to avoid intubation, and it is mainly used in patients with chronic obstructive pulmonary disease exacerbations, acute cardiogenic pulmonary oedema, or in the context of weaning, situations in which a reduction in mortality has been demonstrated. The principal techniques are continuous positive airway pressure and bilevel pressure support ventilation. Whereas non-invasive pressure support ventilation requires a ventilator, continuous positive airway pressure is a simpler technique that can be easily used in non-equipped areas such as the pre-hospital setting. The success of non-invasive ventilation is related to the adequate timing and selection of patients, as well as the appropriate use of interfaces, the synchrony of patient-ventilator, and the fine-tuning of the ventilator.
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6

Masip, Josep, Kenneth Planas y Arantxa Mas. Non-invasive ventilation. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0025_update_002.

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During the last 25 years, the use of non-invasive ventilation has grown substantially. Non-invasive ventilation refers to the delivery of positive pressure to the lungs without endotracheal intubation and plays a significant role in the treatment of patients with acute respiratory failure and in the domiciliary management of some chronic respiratory and sleep disorders. In the intensive and acute care setting, the primary aim of non-invasive ventilation is to avoid intubation, and it is mainly used in patients with chronic obstructive pulmonary disease exacerbations, acute cardiogenic pulmonary oedema, or in the context of weaning, situations in which a reduction in mortality has been demonstrated. The principal techniques are continuous positive airway pressure and bilevel pressure support ventilation. Whereas non-invasive pressure support ventilation requires a ventilator, continuous positive airway pressure is a simpler technique that can be easily used in non-equipped areas such as the pre-hospital setting. The success of non-invasive ventilation is related to the adequate timing and selection of patients, as well as the appropriate use of interfaces, the synchrony of patient-ventilator, and the fine-tuning of the ventilator.
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7

Masip, Josep, Kenneth Planas y Arantxa Mas. Non-invasive ventilation. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0025_update_003.

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During the last 25 years, the use of non-invasive ventilation has grown substantially. Non-invasive ventilation refers to the delivery of positive pressure to the lungs without endotracheal intubation and plays a significant role in the treatment of patients with acute respiratory failure and in the domiciliary management of some chronic respiratory and sleep disorders. In the intensive and acute care setting, the primary aim of non-invasive ventilation is to avoid intubation, and it is mainly used in patients with chronic obstructive pulmonary disease exacerbations, acute cardiogenic pulmonary oedema, immunocompromised or in the context of weaning, situations in which a reduction in mortality has been demonstrated. The principal techniques are continuous positive airway pressure, bilevel pressure support ventilation and more recently, high flow nasal cannula. Whereas non-invasive pressure support ventilation requires a ventilator, the other two techniques are simpler and can be easily used in non-equipped areas by less experienced teams, including the pre-hospital setting. The success of non-invasive ventilation is related to an adequate timing, proper selection of patients and interfaces, close monitoring as well as the achievement of a good adaptation to patients’ demand.
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8

Esmond, Glenda y Christine Mikelsons. Non-Invasive Respiratory Support Techniques: Oxygen Therapy, Non-Invasive Ventilation and CPAP. Wiley & Sons, Incorporated, John, 2009.

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9

Dabo, Liu. Non-Invasive Positive Pressure Ventilation for Pediatric Sleep-Disordered Breathing. Nova Science Publishers, Incorporated, 2014.

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10

Kreit, John W. Noninvasive Mechanical Ventilation. Editado por John W. Kreit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.003.0016.

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Although so-called invasive ventilation can be life-saving, it can also cause significant morbidity. It has long been recognized that positive pressure ventilation can also be delivered “non-invasively” to critically ill patients through several different types of “interfaces” (usually a tight-fitting face mask). Noninvasive Mechanical Ventilation explains when and how to use noninvasive ventilation to treat patients with respiratory failure. It provides a detailed explanation of how noninvasive (bi-level) ventilators differ from the standard ICU ventilators, describes the available modes and breath types as well as the indications and contraindications for noninvasive ventilation, and explains how to initiate, monitor, and adjust noninvasive ventilation.
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11

Fox, Grenville, Nicholas Hoque y Timothy Watts. Respiratory support. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198703952.003.0008.

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This chapter includes sections on various modes of both invasive (i.e. via an endotracheal tube) and non-invasive respiratory support in neonates, including conventional ventilation, volume-targeted ventilation, high-frequency oscillatory ventilation (HFOV), extracorporeal membrane oxygenation (ECMO), nasal continuous positive airways pressure (nCPAP), nasal intermittent positive pressure ventilation (nIPPV), and high and low-flow nasal cannula oxygen. There is also a brief section on the care of babies with a tracheostomy as well as management of babies requiring home oxygen. Reference is made to the most recent European Consensus Guidelines. A separate chapter on neonatal respiratory problems (Chapter 7) gives further detail on common lung pathologies requiring respiratory support in neonates.
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12

Dhand, Rajiv y Michael McCormack. Bronchodilators in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0033.

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Inhaled beta-agonists and anticholinergic agents, as well as systemically administered methylxanthines, are frequently employed to achieve bronchodilation in critically-ill patients. Inhaled agents are given by pressurized metered dose inhaler (pMDI), nebulizer, or dry powder inhaler. In ventilator-supported patients, aerosolized agents are generally only administered by pMDI or nebulizer. The ventilator circuit, artificial airway, and circuit humidity complicate the delivery of aerosolized agents, and there is a wide variability in drug delivery efficiency with various bench models of mechanical ventilation. Aerosolized drug by pMDI is affected by the use of spacer devices, synchronization of pMDI actuation and ventilator breath delivery, and appropriate priming of the pMDI device. The efficiency of aerosolized drug delivery by jet nebulization is also affected by device placement in the circuit, as well as by a number of other factors. Several investigators have demonstrated comparable efficiency of aerosol delivery with mechanically-ventilated and ambulatory patients when careful attention is given to the technique of administration. Appropriate administration of aerosolized bronchodilators in patients receiving invasive or non-invasive positive pressure ventilation produces significant therapeutic effects.
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13

Lee, Jan Hau y Ira M. Cheifetz. Respiratory Failure and Mechanical Ventilation. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0006.

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This chapter on respiratory failure and mechanical ventilation provides essential information about how to support children with severe respiratory disorders. The authors discuss multiple modes of respiratory support, including high-flow nasal cannula oxygen, noninvasive ventilation with continuous positive airway pressure and bilevel positive airway pressure, as well as conventional, high-frequency, and alternative modes of invasive ventilation. The section on invasive mechanical ventilation includes key information regarding gas exchange goals, modes of ventilation, patient–ventilator interactions, ventilator parameters (including tidal volume, end-expiratory pressure, and peak plateau pressure), extubation readiness testing, and troubleshooting. The authors also provide the new consensus definition of pediatric acute respiratory distress syndrome. Also included are multiple figures and indispensable information on adjunctive therapies (inhaled nitric oxide, surfactant, prone positioning, and corticosteroids) and respiratory monitoring (including capnography and airway graphics analysis).
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14

Martin-Loeches, Ignacio y Antonio Artigas. Respiratory support with positive end-expiratory pressure. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0094.

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Positive-end-expiratory pressure (PEEP) is the pressure present in the airway (alveolar pressure) above atmospheric pressure that exists at the end of expiration. The term PEEP is defined in two particular settings. Extrinsic PEEP (applied by ventilator) and intrinsic PEEP (PEEP caused by non-complete exhalation causing progressive air trapping). Applied (extrinsic) PEEP—is usually one of the first ventilator settings chosen when mechanical ventilation (MV) is initiated. Applying PEEP increases alveolar pressure and volume. The increased lung volume increases the surface area by reopening and stabilizing collapsed or unstable alveoli. PEEP therapy can be effective when used in patients with a diffuse lung disease with a decrease in functional residual capacity. Lung protection ventilation is an established strategy of management to reduce and avoid ventilator-induced lung injury and mortality. Levels of PEEP have been traditionally used from 5 to 12 cmH2O; however, higher levels of PEEP have also been proposed and updated in order to keep alveoli open, without the cyclical opening and closing of lung units (atelectrauma). The ideal level of PEEP is that which prevents derecruitment of the majority of alveoli, while causing minimal overdistension; however, it should be individualized and higher PEEP might be used in the more severe end of the spectrum of patients with improved survival. A survival benefit for higher levels of PEEP has not been yet reported for any patient under MV, but a higher PaO2/FiO2 ratio seems to be better in the higher PEEP group.
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15

Romagnoli, Stefano y Giovanni Zagli. Blood pressure monitoring in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0131.

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Two major systems are available for measuring blood pressure (BP)—the indirect cuff method and direct arterial cannulation. In critically-ill patients admitted to the intensive care unit, the invasive blood pressure is the ‘gold standard’ as a tight control of BP values, and its change over time is important for choosing therapies and drugs titration. Since artefacts due to the inappropriate dynamic responses of the fluid-filled monitoring systems may lead to clinically relevant differences between actual and displayed pressure values, before considering the BP value shown as reliable, the critical care giver should carefully evaluate the presence/absence of artefacts (over- or under-damping/resonance). After the arterial pressure waveform quality has been verified, the observation of each component of the arterial wave (systolic upstroke, peak, systolic decline, small pulse of reflected pressure waves, dicrotic notch) may provide a number of useful haemodynamic information. In fact, changes in the arterial pulse contour are due the interaction between the heart beat and the whole vascular properties. Vasoconstriction, vasodilatation, shock states (cardiogenic, hypovolaemic, distributive, obstructive), valve diseases (aortic stenosis, aortic regurgitation), ventricular dysfunction, cardiac tamponade are associated with particular arterial waveform characteristics that may suggest to the physician underlying condition that could be necessary to investigate properly. Finally, the effects of positive-pressure mechanical ventilation on heart–lung interaction, may suggest the existence of an absolute or relative hypovolaemia by means of the so-called dynamic indices of fluid responsiveness.
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16

Li Bassi, Gianluigi y Carles Agusti. Toilet bronchoscopy in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0122.

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Critically-ill patients retain respiratory secretions. Toilet bronchoscopy is applied to aspirate retained secretions and revert lung atelectasis. Toilet bronchoscopy is particularly indicated when retained secretions are visible during the procedureand air-bronchograms are not present at the chest radiograph. Yet, toilet bronchoscopy should only be applied when other less invasive methods of secretion removal have failed. Ventilatory settings during the intervention, the inspiratory fraction of oxygen should be increased to 100%. In volume control ventilation, the pressure limit alarm needs to be increased; during pressure-controlled ventilation, the set inspiratory pressure should be increased. The external PEEP should be decreased to at least 50% of the baseline values, to prevent barotrauma. The use of sedatives, analgesics, and topical anaesthetics is mandatory to achieve favourable procedural condition. Toilet bronchoscopy is also feasible and safe in critically-ill patients undergoing non-invasive ventilation.
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17

Leaver, Susannah y Timothy Evans. Hypoxaemia in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0085.

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Hypoxaemia is a reduction in the partial pressure of oxygen in the blood below 8 kPa/60 mmHg. Hypoxaemia results from one, or several, or a combination of causes. Calculating the alveolar–arterial gradient can help to delineate the cause. Acute respiratory failure manifests in a number of ways, the most sensitive indicator being an increased respiratory rate. Diagnosis is dependent on a comprehensive history, examination in combination with appropriate blood tests, and imaging. Hypoxaemia is the final common pathway of a number of conditions and the exact cause may not be immediately apparent. Despite this, the same management principles apply. A trial of non-invasive ventilation can be used to support patients during respiratory failure who do not require immediate endotracheal intubation. However, it is recommended that this is instituted for a preset trial period (e.g. 1–2 hours) in an HDU/ICU setting where facilities for definitive airway management are available. Invasive ventilation aims to facilitate treatment of the underlying condition whilst minimizing side effects through lung protective ventilatory strategies.
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18

Lei, Yuan. Medical Ventilator System Basics: A clinical guide. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198784975.001.0001.

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Medical Ventilator System Basics: A clinical guide—unlike books that focus on clinical applications, or that provide specifics about individual ventilator models, this is a practical guide about the equipment used for positive pressure mechanical ventilation. This book provides the information a clinician needs every day: how to assemble a ventilator system, how to determine appropriate ventilator settings, how to make sense of monitored data, how to respond to alarms, and how to troubleshoot ventilation problems. The book applies to all ventilators based on the intermittent positive pressure ventilation (IPPV) operating principle. In a systematic and comprehensive way, the book steps the user through the ventilator system, starting with its pneumatic principles to an explanation of the anatomy and physiology of respiration. It describes the system components, including the ventilator, breathing circuit, humidifier, and nebulizer. The book then introduces ventilation modes, starting with an explanation of the building blocks of breath variables and breath types. It describes the major ventilator functions, including control parameters, monitoring, and alarms. Along the way the book provides much practical troubleshooting information. Clearly written and generously illustrated, the book is a handy reference for anyone involved with mechanical ventilation, clinicians and non-clinicians alike. It is suitable as a teaching aid for respiratory therapy education and as a practical handbook in clinical practice.
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19

Junna, Mithri R., Bernardo J. Selim y Timothy I. Morgenthaler. Central sleep apnea and hypoventilation syndromes. Editado por Sudhansu Chokroverty, Luigi Ferini-Strambi y Christopher Kennard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199682003.003.0018.

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Sleep disordered breathing (SDB) may occur in a variety of ways. While obstructive sleep apnea is the most common of these, this chapter reviews the most common types of SDB that occur independently of upper airway obstruction. In many cases, there is concurrent upper airway obstruction and neurological respiratory dysregulation. Thus, along with attempts to correct the underlying etiologies (when present), stabilization of the upper airway is most often combined with flow generators (noninvasive positive pressure ventilation devices) that modulate the inadequate ventilatory pattern. Among these devices, when continuous positive airway pressure (CPAP) alone does not allow correction of SDB, adaptive servo-ventilation (ASV) is increasingly used for non-hypercapnic types of central sleep apnea (CSA), while bilevel PAP in spontaneous-timed mode (BPAP-ST) is more often reserved for hypercapnic CSA/alveolar hypoventilation syndromes. Coordination of care among neurologists, cardiologists, and sleep specialists will often benefit such patients.
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20

Kreit, John W. Acute Respiratory Distress Syndrome (ARDS). Editado por John W. Kreit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.003.0012.

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Acute Respiratory Distress Syndrome reviews the definitions, causes, pathophysiology, and management of this relatively common, life-threatening disorder. This chapter describes how to ensure adequate tissue oxygen delivery while minimizing ventilator-induced lung injury and provides an in-depth review of how to determine the optimum level of positive end-expiratory pressure (PEEP). The first topic addressed is the precipitating factors and pathophysiology of acute respiratory distress syndrome. Next the chapter turns to mechanical ventilation, and covers the subjects of adequate oxygenation, ventilator-induced lung injury, ancillary therapies, ventilatory therapies, and high I:E ventilation. The topics addressed in the area of non-ventilatory therapies include: prone positioning of the patient, neuromuscular blockade, inhaled vasodilators, and extracorporeal membrane oxygenation (ECMO).
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21

Pittman, Marcus y Adrian Williams. Central sleep apnoea. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0005.

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Central sleep apnoea and Cheyne-Stokes respiration are common forms of sleep-disordered breathing, particularly in patients with co-morbidities such as cardiac and renal disease which, however, often do not require specific treatment. Physicians may encounter such patients in their outpatient clinics or as ward referrals in hospital. A typical case is presented to aid the approach to such patients, including how to make an accurate diagnosis, which of the various treatment modalities to use, and what to do if a treatment fails. The evidence for the different interventions is explored, including oxygen, modes of non-invasive positive airway pressure, and drug treatments, with particular attention to groundbreaking studies.
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