Livres : « Mechanic ventilator »

1

Arnal, Jean-Michel. Monitoring Mechanical Ventilation Using Ventilator Waveforms. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-58655-7.

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1955-, Mishoe Shelley C., dir. Ventilator concepts : A systematic approach to mechanical ventilators. San Diego, Calif : California College for Health Sciences, 1987.

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3

M, Kacmarek Robert, dir. Essentials of mechanical ventilation. New York : McGraw-Hill, Health Professions Division, 1996.

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4

Lemaire, François, dir. Mechanical Ventilation. Berlin, Heidelberg : Springer Berlin Heidelberg, 1991. http://dx.doi.org/10.1007/978-3-642-87448-2.

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5

Slutsky, Arthur S., et Laurent Brochard, dir. Mechanical Ventilation. Berlin, Heidelberg : Springer Berlin Heidelberg, 2004. http://dx.doi.org/10.1007/b138096.

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6

Kreit, John W. Mechanical ventilation. Oxford : Oxford University Press, 2013.

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7

François, Lemaire, dir. Mechanical ventilation. Berlin : Springer-Verlag, 1991.

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8

MacIntyre, Neil R., et Richard D. Branson, dir. Mechanical ventilation. Philadelphia, Pennsylvana : W.B. Saunders, 2001.

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9

MacIntyre, Neil R. Mechanical ventilation. Philadelphia : Saunders Elsevier, 2001.

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10

MacIntyre, Neil R., et Richard D. Branson. Mechanical Ventilation. Philadelphia : Saunders, 2000.

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11

R, MacIntyre Neil, et Branson Richard D, dir. Mechanical ventilation. 2^e éd. St. Louis, MO : Saunders Elsevier, 2009.

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12

R, Kirby Robert, Smith, Robert A., R.R.T. et Desautels David A, dir. Mechanical ventilation. New York : Churchill Livingstone, 1985.

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13

M, Kacmarek Robert, dir. Essentials of mechanical ventilation. 2^e éd. New York : McGraw-Hill, Health Professions Division, 2002.

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14

Esquinas, Antonio Matías, dir. Noninvasive Mechanical Ventilation. Berlin, Heidelberg : Springer Berlin Heidelberg, 2010. http://dx.doi.org/10.1007/978-3-642-11365-9.

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15

Esquinas, Antonio M., dir. Noninvasive Mechanical Ventilation. Cham : Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-21653-9.

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16

Hasan, Ashfaq. Understanding Mechanical Ventilation. London : Springer London, 2010. http://dx.doi.org/10.1007/978-1-84882-869-8.

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17

Hidalgo, Jorge, Robert C. Hyzy, Ahmed Mohamed Reda Taha et Yasser Younis A. Tolba, dir. Personalized Mechanical Ventilation. Cham : Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-14138-6.

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18

1961-, Raoof Suhail, et Khan Faroque A, dir. Mechanical ventilation manual. Philadelphia, PA : American College of Physicians, 1998.

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19

Christine, Stock M., et Perel Azriel, dir. Handbook of mechanical ventilatory support. 2^e éd. Baltimore : Williams & Wilkins, 1997.

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Azriel, Perel, et Stock M. Christine, dir. Handbook of mechanical ventilatory support. Baltimore : Williams & Wilkins, 1991.

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21

Poor, Hooman. Basics of Mechanical Ventilation. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-89981-7.

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22

Mancebo, Jordi, Alvar Net et Laurent Brochard, dir. Mechanical Ventilation and Weaning. Berlin, Heidelberg : Springer Berlin Heidelberg, 2002. http://dx.doi.org/10.1007/978-3-642-56112-2.

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23

Potter, I. N. CO2 controlled mechanical ventilation. Bracknell : BSRIA, 1994.

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24

Lucangelo, Umberto, et Massimo Ferluga. Pulmonary mechanical dysfunction in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0084.

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In intensive care units practitioners are confronted every day with mechanically-ventilated patients and should be able to sort out from all the data available from modern ventilators to tailored patient ventilatory strategy. Real-time visualization of pressure, flow and tidal volume provide valuable information on the respiratory system, to optimize ventilatory support and avoiding complications associated with mechanical ventilation. Early determination of patient–ventilator asynchrony, air-trapping, and variation in respiratory parameters is important during mechanical ventilation. A correct evaluation of data becomes mandatory to avoid a prolonged need for ventilatory support. During dynamic hyperinflation the lungs do not have time to reach the functional residual capacity at the end of expiration, increasing the work of breathing and promoting patient-ventilator asynchrony. Expiratory capnogram provides qualitative information on the waveform patterns associated with mechanical ventilation and quantitative estimation of expired CO2. The concept of dead space accounts for those lung areas that are ventilated but not perfused. Calculations derived from volumetric capnography are useful indicators of pulmonary embolism. Moreover, alveolar dead space is increased in acute lung injury and its value decreased in case of positive end-expiratory pressure (PEEP)-induced recruitment, whereas PEEP-induced overdistension tends to increment alveolar dead space.

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25

Oliver, Charles M., et S. Ramani Moonesinghe. Setting rate, volume, and time in ventilatory support. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0093.

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Ventilator rate, volume, and time parameters are interrelated directly, mechanically, and physiologically, and interactions between intrinsic pulmonary physio-mechanics, pathology and the effects of mechanical ventilation complex. The physiological consequences of mechanical ventilation and risks of ventilator-induced trauma may be exacerbated by lung pathology. Programming of ventilator parameters should be considered within the context of an individualized ventilatory strategy to achieve adequate gas exchange, while minimizing attendant risks of mechanical ventilation. Recommended strategies should be modified within accepted limits to mitigate disease-specific risks. Parameters should subsequently be titrated against blood gas- and ventilator-derived targets, and other clinical variables.

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Fanelli, Vito, et V. Marco Ranieri. Failure to ventilate in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0100.

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Mechanical ventilation is an efficacious therapy to respiratory failure because it improves gas exchange and rests respiratory muscles. During controlled mechanical ventilation, a patient’s inspiratory muscles are resting and the ventilator delivers a preset tidal volume through the generation of inspiratory flow, overcoming resistive and elastic thresholds of the respiratory system. During assisted ventilation, the same goal is reached through an interplay between the patient’s inspiratory muscles and ventilator. Every perturbation of this interaction causes patient ventilator asynchrony and exposes to the risk of failure to ventilate. Patient–ventilator asynchrony may occur at each stage of assisted breath Signs of patient’s discomfort, the use of accessory muscles, tachycardia, hypertension, and assessment of flow and airway pressure traces displayed on modern ventilators, helps to detect asynchronies. Prompt recognition and intervention to improve patient–ventilator interaction may expedite liberation from mechanical ventilation, and reduce intensive care unit and length of hospital stay.

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MacIntyre, Neil R. Indications for mechanical ventilation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0091.

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Mechanical ventilation is indicated when the patient’s ability to ventilate the lung and/or effect gas transport across the alveolar capillary interface is compromised to point that harm is imminent. In practice, this means addressing one or more of three fundamental pathophysiological processes—loss of proper ventilatory control, ventilatory muscle demand-capability imbalances, and/or loss of alveolar patency. A fourth general indication involves providing a positive pressure assistance to allow tolerance of an artificial airway in the patient unable to maintain a patent and protected airway. The decision to initiate mechanical ventilation usually involves an integrated assessment that should include mental status, airway protection capabilities, ventilatory muscle load tolerance, spontaneous ventilatory pattern, and signs of organ dysfunction from either acidosis and/or hypoxaemia. Providing mechanical ventilatory assistance can be life-sustaining, but it is associated with significant risk, including ventilator-induced lung injury, infection, and need for sedatives/paralytics, and must be applied only when indications justify the risk.

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28

Kreit, John W., et John A. Kellum. Mechanical Ventilation. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.001.0001.

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Mechanical Ventilation—Physiology and Practice provides a comprehensive review of the physiological principles underlying mechanical ventilation, as well as practical approaches to the management of patients with respiratory failure. The book explains instrumentation and terminology, ventilator modes and breath types, ventilator alarms, how to write ventilator orders, and how to diagnose and correct patient–ventilator asynchrony. It also discusses the physiological assessment of the mechanically ventilated patient and the diagnosis and management of dynamic hyperinflation, and describes how to manage patients with the acute respiratory distress syndrome (ARDS), severe obstructive lung disease, and right ventricular failure; how to “wean” patients from the ventilator; and how and when to use noninvasive ventilation.

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Waldmann, Carl, Neil Soni et Andrew Rhodes. Respiratory monitoring. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199229581.003.0006.

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Pulmonary function tests in critical illness 90End-tidal CO2 monitoring 92Pulse oximetry 94Pulmonary function test results in critically ill patients can be important prognostically and guide ventilatory and weaning strategies. However, they are not straightforward to measure in mechanically ventilated patients and remain limited to dynamic volumes. Fortunately, most modern mechanical ventilators are able to calculate and display static and dynamic lung volumes, together with derived values for airway resistance, compliance and flow/volume/time curves. The ability to monitor these changes after altering ventilatory parameters has enabled more sophisticated adjustments of ventilation, to prevent potentially damaging mechanical ventilation....

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Nava, Stefano, et Luca Fasano. Ventilator Liberation Strategies. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199653461.003.0039.

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The weaning process should ideally begin as soon as the patient is intubated and continue through the treatment of the cause inducing acute respiratory failure. Weaning includes the assessment of readiness to extubate, extubation, and post-extubation monitoring; it also includes consideration of non-invasive ventilation which has been shown to reduce the duration of invasive mechanical ventilation in selected patients. Weaning accounts for approximately 40% of the total time spent on mechanical ventilation and should be achieved rapidly, since prolonged mechanical ventilation is associated with increased risk of complications and mortality and with increased costs. During mechanical ventilation, medical management should seek to correct the imbalance between respiratory load and ventilatory capacity (reducing the respiratory and cardiac workload, improving gas exchange and the ventilatory pump power). Ventilator settings delivering partial ventilatory pump support may help prevent ventilator-induced respiratory muscles dysfunction. Daily interruption of sedation has been associated with earlier extubation. Critically ill patients should be repeatedly and carefully screened for readiness to wean and readiness to extubate, and objective screening variables should be fully integrated in clinical decision making.

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31

Kreit, John W. Instrumentation and Terminology. Sous la direction de John W. Kreit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.003.0004.

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Instrumentation and Terminology describes the general design of mechanical ventilators, reviews the functions of the ventilator–user interface, and defines and explains commonly used terms and acronyms associated with mechanical ventilators. Despite big differences in outward appearance, all mechanical ventilators have several basic features in common. All must be connected to high-pressure sources of oxygen and air. All ventilators have a user interface, which allows the clinician to easily choose from a wide variety of ventilator settings, and displays these settings, as well as important, real-time patient data. Tables 4.1 and 4.2 in this chapter list most of the terms that you’ll need to use and understand when caring for mechanically ventilated patients.

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32

Chatburn, Robert L., et Eduardo Mireles-Cabodevila. Design and function of mechanical ventilators. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0092.

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This chapter presents a new approach to understanding the design and function of mechanical ventilators. Mechanical ventilators have become so complex that a practical classification system or taxonomy is required to compare and contrast treatment options. This chapter describes the 10 fundamental maxims from which we construct a taxonomy to describe each mode of mechanical ventilation. This method provides a framework for the comparison of published studies of mechanical ventilation, gives consistency in education and clinical practice. It also allows comparisons between different ventilator manufacturers and, most importantly, it provides a framework to match modes to specific patient needs.

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33

Arnal, Jean-Michel. Monitoring Mechanical Ventilation Using Ventilator Waveforms. Springer, 2018.

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34

Lei, Yuan. Mechanical Ventilation Modes. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198784975.003.0008.

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‘Mechanical Ventilation Modes’ seeks to shed light on this hotly debated topic, one that is complicated by ventilator manufacturers’ non-standardized terminology. The chapter looks at conventional modes, adaptive modes, and biphasic modes, which it classifies based on the mechanical breath types in each mode. It includes a comparison chart of the terminology used for common modes on popular IPPV ventilators. Using their signature waveforms, the author describes the assist/control, SIMV, and pressure support ventilation or PSV modes. It defines the modes by their application of spontaneous breaths and mandatory breaths. It continues with a discussion of adaptive modes and biphasic modes. It ends by discussing how to select the appropriate ventilation mode.

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35

Abuella, Gihan, et Andrew Rhodes. Mechanical ventilation. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0024.

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Mechanical ventilation is used to assist or replace spontaneous respiration. Gas flow can be generated by negative pressure techniques, but it is positive pressure ventilation that is the most efficacious in intensive care. There are numerous pulmonary and extrapulmonary indications for mechanical ventilation, and it is the underlying pathology that will determine the duration of ventilation required. Ventilation modes can broadly be classified as volume- or pressure-controlled, but modern ventilators combine the characteristics of both in order to complement the diverse requirements of individual patients. To avoid confusion, it is important to appreciate that there is no international consensus on the classification of ventilation modes. Ventilator manufacturers can use terms that are similar to those used by others that describe very different modes or have completely different names for similar modes. It is well established that ventilation in itself can cause or exacerbate lung injury, so the evidence-based lung-protective strategies should be adhered to. The term acute lung injury has been abolished, whilst a new definition and classification for the acute respiratory distress syndrome has been defined.

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Grounds, Robert O., et Andrew Rhodes. Mechanical ventilation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0024_update_001.

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Mechanical ventilation is used to assist or replace spontaneous respiration. Gas flow can be generated by negative pressure techniques, but it is positive pressure ventilation that is the most efficacious in intensive care. There are numerous pulmonary and extrapulmonary indications for mechanical ventilation, and it is the underlying pathology that will determine the duration of ventilation required. Ventilation modes can broadly be classified as volume- or pressure-controlled, but modern ventilators combine the characteristics of both in order to complement the diverse requirements of individual patients. To avoid confusion, it is important to appreciate that there is no international consensus on the classification of ventilation modes. Ventilator manufacturers can use terms that are similar to those used by others that describe very different modes or have completely different names for similar modes. It is well established that ventilation in itself can cause or exacerbate lung injury, so the evidence-based lung-protective strategies should be adhered to. The term acute lung injury has been abolished, whilst a new definition and classification for the acute respiratory distress syndrome has been defined.

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Kreit, John W. Acute Respiratory Distress Syndrome (ARDS). Sous la direction de 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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Kreit, John W. Ventilator Modes and Breath Types. Sous la direction de John W. Kreit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.003.0005.

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Ventilator Modes and Breath Types describes, compares, and contrasts the different modes and breath types that are available on intensive care unit ventilators. The chapter first covers the various ventilator modes: continuous mandatory ventilation, synchronized intermittent mandatory ventilation, spontaneous ventilation, and bi-level ventilation. Then it turns to a discussion of the various mechanical breath types: volume control, pressure control, adaptive pressure control, pressure support, and finally, adaptive pressure support. It also provides practical advice about how and when to use each mode–breath type combination. Eight Boxes in the chapter discuss each breath type, and list each type’s features, and its clinician-set parameters.

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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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Muders, Thomas, et Christian Putensen. Pressure-controlled mechanical ventilation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0096.

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Beside reduction in tidal volume limiting peak airway pressure minimizes the risk for ventilator-associated-lung-injury in patients with acute respiratory distress syndrome. Pressure-controlled, time-cycled ventilation (PCV) enables the physician to keep airway pressures under strict limits by presetting inspiratory and expiratory pressures, and cycle times. PCV results in a square-waved airway pressure and a decelerating inspiratory gas flow holding the alveoli inflated for the preset time. Preset pressures and cycle times, and respiratory system mechanics affect alveolar and intrinsic positive end-expiratory (PEEPi) pressures, tidal volume, total minute, and alveolar ventilation. When compared with flow-controlled, time-cycled (‘volume-controlled’) ventilation, PCV results in reduced peak airway pressures, but higher mean airway. Homogeneity of regional peak alveolar pressure distribution within the lung is improved. However, no consistent data exist, showing PCV to improve patient outcome. During inverse ratio ventilation (IRV) elongation of inspiratory time increases mean airway pressure and enables full lung inflation, whereas shortening expiratory time causes incomplete lung emptying and increased PEEPi. Both mechanisms increase mean alveolar and transpulmonary pressures, and may thereby improve lung recruitment and gas exchange. However, when compared with conventional mechanical ventilation using an increased external PEEP to reach the same magnitude of total PEEP as that produced intrinsically by IRV, IRV has no advantage. Airway pressure release ventilation (APRV) provides a PCV-like squared pressure pattern by time-cycled switches between two continuous positive airway pressure levels, while allowing unrestricted spontaneous breathing in any ventilatory phase. Maintaining spontaneous breathing with APRV is associated with recruitment and improved ventilation of dependent lung areas, improved ventilation-perfusion matching, cardiac output, oxygenation, and oxygen delivery, whereas need for sedation, vasopressors, and inotropic agents and duration of ventilator support decreases.

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Shkreli, Buffy. Care of Patients on Ventilators : Strategies to Improve Care for Mechanical Ventilation Patients : Home Ventilator Training. Independently Published, 2021.

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42

Aguirre-Bermeo, Hérnan, et Jordi Mancebo. Pressure support ventilation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0097.

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Pressure support ventilation (PSV) is one of the most common ventilatory modalities used in intensive care units. PSV is an assisted, pressure-limited, and flow-cycled ventilatory mode. The ventilator provides assistance when the patient makes a breathing effort, and when inspiratory flow reaches a certain threshold level, cycling to exhalation occurs. PSV unloads respiratory muscle effort, while allowing the patient to retain control over the respiratory rate and tidal volume. Withdrawal from mechanical ventilation should be performed with a gradual reduction of levels of support until extubation. Asynchronies can be present during PSV and are typically associated with high levels of support. A closed-loop modality, which adjusts support levels to keep the patient in a ‘comfort zone’, has been designed to assist in the withdrawal of mechanical ventilation. It performs at least as well as experienced medical staff and could be useful in specific groups of patients.

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Bauman, Kristy A., et Robert C. Hyzy. Volume-controlled mechanical ventilation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0095.

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The goal of mechanical ventilation is to achieve adequate gas exchange while minimizing haemodynamic compromise and ventilator-associated lung injury. Volume-controlled ventilation can be delivered via several modes, including controlled mechanical ventilation, assist control (AC) and synchronized intermittent mandatory ventilation (SIMV). .In volume-controlled modes, the clinician sets the flow pattern, flow rate, trigger sensitivity, tidal volume, respiratory rate, positive end-expiratory pressure, and fraction of inspired oxygen. Patient ventilator synchrony can be enhanced by setting appropriate trigger sensitivity and inspiratory flow rate. I:E ratio can be adjusted to improve oxygenation, avoid air trapping and enhance patient comfort. There is little data regarding the benefits of one volume-controlled mode over another. In acute respiratory distress syndrome, low tidal volume ventilation in conjunction with plateau pressure limitation should be employed as there is a reduction in mortality with this strategy. This chapter addresses respiratory mechanics, modes and settings, clinical applications, and limitations of volume-controlled ventilation.

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Kreit, John W. Noninvasive Mechanical Ventilation. Sous la direction de 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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Kreit, John W. Ventilator Alarms—Causes and Evaluation. Sous la direction de John W. Kreit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.003.0006.

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When a patient is intubated and placed on mechanical ventilation, the clinician must write a series of ventilator orders. It’s important to recognize though, that several other parameters are typically set by the respiratory therapist without direct physician input. The most important are the critical values that will trigger a ventilator alarm. ICU ventilators constantly monitor many machine and patient-related variables, including airway pressure, flow rate, volume, and respiratory rate, and it seems like there’s an alarm for almost everything. While it’s true that some alarms are of little or no significance, others may indicate an important and potentially life-threatening problem. Ventilator Alarms—Causes and Evaluation describes important ventilator alarms and how each is set and triggered. It also reviews how to determine the cause of each ventilator alarm and how to correct the identified problems.

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Lee, Jan Hau, et 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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Lei, Yuan. Introduction. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198784975.003.0001.

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The ‘Introduction’ chapter presents the concept of the entire ventilator system, whose understanding is crucial for the clinician performing mechanical ventilation. Mechanical ventilation is a risky, expensive, and error-prone therapy, the author asserts, which is why it is so important to understand not just the clinical application of ventilation, but also the equipment used in ventilation therapy. Furthermore, the ventilator must be viewed within the context of the larger ventilation system. This chapter defines the book’s audiences and discusses its value to them.

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Kreit, John W. Discontinuing Mechanical Ventilation. Sous la direction de John W. Kreit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.003.0015.

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Discontinuing Mechanical Ventilation provides clear, step-by step instructions on how to liberate or “wean” the patient from the ventilator. It explains how to determine when the patient is ready to begin the weaning process, how to perform a spontaneous breathing trial, and how to determine if the patient is ready for extubation, including such considerations as whether the patient is at risk for post-extubation laryngeal edema; whether the patient will be able to effectively clear secretions from the airways following extubation; and determining if the patient has a “difficult airway” should the need for re-intubation arise. The chapter also provides a step-by-step approach to the difficult-to-wean patient, covering topics such as how to assess ventilatory ability and demand; determine the cause(s) of increased demand, impaired ability, or both; treat the causes of increased demand and impaired ability; and determine when to perform a tracheostomy.

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49

Perry, Sally Anne G. VALIDATION OF A WEANING SCORE INSTRUMENT (VENTILATOR, RESPIRATOR, MECHANICAL VENTILATION). 1991.

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50

Kreit, John W. How to Write Ventilator Orders. Sous la direction de John W. Kreit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.003.0008.

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How to Write Ventilator Orders provides step-by-step instructions on how to write ventilator orders—how to choose appropriate settings immediately after intubation; how to adjust ventilator settings throughout the course of the patient’s illness; and when weaning the patient from mechanical ventilation—how to write orders for spontaneous breathing trials. For writing initial ventilator orders, we discuss: choosing a mode of mechanical ventilation, choosing the type of mechanical breath, selecting settings based on the type of mechanical breath, and specifying other basic settings. Next, the chapter covers recommended adjustments to settings in cases of high PaO2 and SpO2, low PaO2 andSpO2, and respiratory acidosis and alkalosis. A table at the end of the chapter shows the orders needed to perform an on-ventilator spontaneous breathing trial.

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