Livres : « Mechanical ventilation system »

1

Respiratory system and artificial ventilation. Milan : Springer, 2008.

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2

A, Moore James. Troubleshooting a mechanical ventilation system for livestock or poultry housing. [Corvallis, Or.] : Oregon State University Extension Service, Washington State University Cooperative Extension, the University of Idaho Cooperative Extension Service and the U.S. Dept. of Agriculture, 1986.

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3

Sheet Metal and Air Conditioning Contractors' National Association (U.S.), dir. Residential comfort system installation standards manual. 7^e éd. Chantilly, VA : SMACNA, 1998.

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4

Potter, I. N. CO2 controlled mechanical ventilation systems. Bracknell : Building Services Research and Information Association, 1994.

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5

Timothy, Mayo, Prowskiw G, Canada Centre for Mineral and Energy Technology. Efficiency and Alternative Energy Technology Branch. et Unies Ltd, dir. Utilization of residential mechanical ventilation systems. Ottawa : CANMET, Efficiency and Alternative Energy Technology Branch, 1992.

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6

Chartered Institution of Building Services Engineers, dir. Improved life cycle performance of mechanical ventilation systems. London : CIBSE, 2003.

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7

Proskiw, G. Field performance of various types of residential mechanical ventilation systems. [Ottawa, Ont.] : Energy, Mines and Resources Canada, 1992.

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8

Krigger, John. Saturn mechanical systems field guide. [Helena, MT] : Saturn Resource Management, 2006.

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9

W, Haines Roger. Control Systems for Heating, Ventilating, and Air Conditioning. Boston, MA : Springer US, 1993.

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10

M, Porterfield John, Kirsininkas Ronald et Balderas David, dir. Mechanical systems retrofit manual : A guide for residential design. New York : Van Nostrand Reinhold Co., 1987.

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11

Konkel, James H. Rule-of-thumb cost estimating for building mechanical systems : Accurate estimating and budgeting using unit assembly costs. New York : McGraw-Hill, 1987.

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12

Schwenk, David M. Standard HVAC control systems : Operation and maintenance for maintenance mechanics. [Champaign, IL : U.S. Army Construction Engineering Research Laboratories, 1996.

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13

Sheet Metal and Air Conditioning Contractors' National Association (U.S.). Fire and Smoke Control Committee. Fire, smoke and radiation damper installation guide for HVAC systems. 5^e éd. Chantilly, VA : Sheet Metal and Air Conditioning Contractors' National Association, 2002.

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14

Sheet Metal and Air Conditioning Contractors' National Association. Fire and Smoke Control Committee., dir. Fire, smoke, and radiation damper installation guide for HVAC systems. 4^e éd. Chantilly, Va. (4201 Lafayette Center Dr., Chantilly 22021-1209) : SMACNA, 1992.

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15

Sugarman, Samuel C. HVAC systems : Operation, maintenance, & optimization. Englewood Cliffs, NJ : Prentice Hall, 1992.

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16

Testing and balancing HVAC air and water systems. Lilburn, GA : Fairmont Press, 1990.

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Testing and balancing HVAC air and water systems. Lilburn, GA : The Fairmont Press, Inc., 2014.

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Testing and balancing HVAC air and water systems. 4^e éd. Lilburn, GA : Fairmont Press, 2006.

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19

Sugarman, Samuel C. Testing and balancing HVAC air and water systems. 2^e éd. Lilburn, GA : Fairmont Press, 1995.

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20

Sugarman, Samuel C. Testing and balancing HVAC air and water systems. 3^e éd. Lilburn, GA : Fairmont Press, 2000.

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21

Sheet Metal and Air Conditioning Contractors' National Association (U.S.), dir. Installation standards for residential heating and air conditioning systems. 6^e éd. Vienna, Va. (8224 Old Courthouse Rd., Vienna 22180) : Sheet Metal and Air Conditioning Contractors National Association, 1988.

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22

Coffin, Michael J. Direct Digital Control for Building HVAC Systems. Boston, MA : Springer US, 1999.

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23

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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24

Lei, Yuan. Lung Ventilation : Natural and Mechanical. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198784975.003.0003.

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‘Lung Ventilation: Natural and Mechanical’ describes the processes of respiration and lung ventilation, focusing on those issues related directly to mechanical ventilation. The chapter starts by discussing the anatomy and physiology of respiration, and the involvement of the lungs and the entire respiratory system. It continues by introducing the three operating principles of mechanical ventilation. It then narrows its focus to intermittent positive pressure ventilation (IPPV), the operating principle of most modern critical care ventilators, explaining the pneumatic process of IPPV. The chapter ends by comparing natural and mechanical/artificial lung ventilation.

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25

Lei, Yuan. Ventilator System Concept. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198784975.003.0004.

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‘Ventilator System Concept’ develops the idea that the equipment for mechanical ventilation is a ventilator system with six essential parts. Using a simple balloon model, it explains the operating principle and composition of a ventilator system, and it describes how the system generates intermittent positive airway pressure. The chapter ends by describing the conditions required for a ventilator system to function properly.

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26

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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27

Kreit, John W. Respiratory Failure and the Indications for Mechanical Ventilation. Sous la direction de John W. Kreit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.003.0007.

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Respiratory failure occurs when a disease process significantly interferes with the respiratory system’s vital functions and causes arterial hypoxemia, hypercapnia, or both. Typically, respiratory failure is divided into three categories based on the underlying pathophysiology: ventilation failure, oxygenation failure, and oxygenation-ventilation failure. With severe disturbances in gas exchange, mechanical ventilation is often needed to assist the respiratory system and restore the PaCO2, PaO2, or both, to normal. Respiratory Failure and the Indications for Mechanical Ventilation defines and describes the three types of respiratory failure and reviews the four indications for intubation and mechanical ventilation—acute or acute-on-chronic hypercapnia, refractory hypoxemia, inability to protect the lower airway, and upper airway obstruction.

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28

Cordioli, Ricardo Luiz, et Laurent Brochard. Respiratory system compliance and resistance in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0074.

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Under mechanical ventilation, monitoring of respiratory mechanics is fundamental, especially in patients with abnormal mechanics. In order to appropriately set the ventilator, clinicians need to understand the relationship between pressure, volume and flow. To move air in and out the thorax, energy must be dissipated against elastic and resistive forces. Elastance is the pressure to volume ratio and necessitates an end inspiratory occlusion to measure the so-called plateau pressure. Resistance is the ratio between pressure dissipated and mean gas flow. Finally, the total positive end expiratory pressure must be measured with an end expiratory occlusion. Volume-controlled ventilation is the recommended mode to assess respiratory mechanics of a passive patient. Clinicians must be aware that both chest wall and lung participate in forces imposed by the respiratory system. An oesophageal catheter can estimate pleural pressure, and used to partition the respective role of the lung and the chest wall.

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29

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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30

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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31

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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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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33

Kreit, John W. Patient–Ventilator Interactions and Asynchrony. Sous la direction de John W. Kreit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.003.0011.

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Patient–Ventilator Interactions and Asynchrony describes what happens when the patient and the ventilator do not work together in an effective, coordinated manner. Effective mechanical ventilation requires the synchronized function of two pumps: The mechanical ventilator is governed by the settings chosen by the clinician; the patient’s respiratory system is controlled by groups of neurons in the brain stem. Ideally, the ventilator simply augments and amplifies the activity of the respiratory system. Asynchrony between the ventilator and the patient reduces patient comfort, increases work of breathing, predisposes to respiratory muscle fatigue, and may even impair oxygenation and ventilation. The chapter describes the causes and consequences of patient–ventilator asynchrony during ventilator triggering and the inspiratory phase of the respiratory cycle and explains how to adjust ventilator settings to improve patient comfort and reduce the work of breathing.

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Kreit, John W. Respiratory Mechanics. Sous la direction de John W. Kreit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.003.0001.

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Ventilation can occur only when the respiratory system expands above and then returns to its resting or equilibrium volume. This is just another way of saying that ventilation depends on our ability to breathe. Although breathing requires very little effort and even less thought, it’s nevertheless a fairly complex process. Respiratory Mechanics reviews the interaction between applied and opposing forces during spontaneous and mechanical ventilation. It discusses elastic recoil, viscous forces, compliance, resistance, and the equation of motion and the time constant of the respiratory system. It also describes how and why pleural, alveolar, lung transmural, intra-abdominal, and airway pressure change during spontaneous and mechanical ventilation, and the effect of applied positive end-expiratory pressure (PEEP).

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Kahn, Jeremy M. The Role of Long-Term Ventilator Hospitals. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199653461.003.0004.

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Long-term ventilator facilities play an increasingly important role in the care of chronically critically ill patients in the recovery phase of their acute illness. These hospitals can take several forms, depending on the country and health system, including �step-down� units within acute care hospitals and dedicated centres that specialize in weaning patients from prolonged mechanical ventilation. These hospitals may improve outcomes through increased clinical experience at applying protocolized weaning approaches and specialized, multidisciplinary, rehabilitation-focused care; they may also worsen outcomes by fragmenting the episode of acute care across multiple hospitals, leading to communication delays and hardship for families. Long-term ventilator facilities may also have important �spillover effects�, in that they free ICU beds in acute care hospitals to be filled with greater numbers of acute critically ill patients. Current evidence suggests that mortality of chronically critically ill patients is equivalent between acute care hospitals and specialized weaning centres; however, mechanical ventilation may be longer and cost of care higher in patients who remain in acute care hospitals. Given the rising incidence of prolonged mechanical ventilation and capacity constraints on acute care ICUs, long-term ventilator hospitals are likely to serve a key function in critical illness recovery.

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Goodman, Lawrence R. Imaging the respiratory system in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0078.

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Routine radiographs are not cost effective in the intensive care unit (ICU) setting. Most published guidelines agree that radiographs are worthwhile after insertion of tubes or catheters, and in patients receiving mechanical ventilation. Otherwise, they are required only for change in the patient’s clinical status. Picture archiving and communication systems utilize digital imaging technology. They provide superior quality images, rapid image availability at multiple sites, and fewer repeat examinations, reducing both cost and patient radiation. Disadvantages of picture archiving and communication systems include expensive equipment and personnel required to keep them functioning. The majority of chest X-ray abnormalities in the ICU are best understood by paying careful attention to the initial appearance of the X-ray in relation to the patient’s onset of symptoms and the progression of abnormalities over the next few days.

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37

Potter, I. N. Ventilation Effectiveness in Mechanical Ventilation Systems (Bsria Bibliography). Hyperion Books, 1988.

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38

Estates, Great Britain : NHS. Mechanical Ventilation and Air Conditioning Systems. Stationery Office, The, 1999.

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39

Chiarandini, Paolo, et Giorgio Della Rocca. Post-operative ventilatory dysfunction management in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0362.

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Alterations in respiratory function and gas exchanges are frequently seen in patients during anaesthesia and in the post-operative period. Mechanical ventilation and drugs such as neuromuscular blocking agents can alter normal function of the respiratory system and cause damage to lungs. Protective ventilation strategies should always be adopted intra-operatively in mechanically-ventilated patients. A neuromuscular monitoring-guided use of decurarizating agents and post-operative adequate analgesia techniques are recommended to avoid post-operative residual curarization and pain. Pneumonia is the most frequent infective complication, but at the moment there are no recommended clinical tools (scoring systems) to identify patients at high. A fast-track surgical approach and early can decrease the risk. Early mobilization and prophylactic low molecular weight heparins use have a well-documented efficacy on prevention of pulmonary embolism. There is still no general consensus on the widespread use of early NIV in post-operative patients, although in selected high-risk patients it could help respiratory recovery and reduce complications.

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40

Knight, Paul A. Mechanical systems retrofit manual. Van Nostrand Reinhold, 1987.

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41

Wijdicks, Eelco F. M., et Sarah L. Clark. Analgosedation and Neuromuscular Blockers. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190684747.003.0002.

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Sedation is beneficial to many restless patients but it may prolong the length of stay in the intensive care unit, prolong time on the ventilator, and have negative effects on the cardiovascular system, causing hemodynamic instability. Use of neuromuscular blockers has decreased due to better awareness of the risks. These risks include prolonged intensive-care-unit–acquired weakness, prolonged mechanical ventilation, risk of patient awareness during paralysis, risk for venous thromboembolism, and anaphylaxis. It is therefore important to have a good knowledge of these drugs and when to use them. This chapter provides a rationale of how to use sedatives and neuromuscular blockers in neurocritically ill patients.

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42

Mechanical ventilating systems for livestock housing. Ames, Iowa : The Service, 1990.

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43

Hough, Catherine L. Chronic critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0377.

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Chronic critical illness (CCI) is common and describes a state of prolonged critical illness, in which patients have persisting organ failures requiring treatment in an intensive care setting. There are many different definitions of CCI, with most including prolonged (> 96 hours) mechanical ventilation. Advanced age, higher severity of illness, and poor functional status prior to critical illness are all important risk factors, but prediction of CCI is imperfect. Although requirement for mechanical ventilation is the hallmark, CCI encompasses much more than the respiratory system, with effects on metabolism, skin, brain, and neuromuscular function. During CCI, patients have a high burden of symptoms and impaired capacity to communicate their needs. Mortality and quality of life are generally poor, but highly variable, with 1-year mortality over 50% and most survivors suffering permanent cognitive impairment and functional dependence. Patients at highest and lowest risk for mortality can be identified using a simple prediction rule. Caring for the chronically critically ill is a substantial burden both to patients’ families and to the health care system as a whole. Further research is needed in order to improve care and outcomes for CCI patients and their families.

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E Cox, Christopher. Costs and Resource Utilization in Prolonged Critical Illness. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199653461.003.0008.

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Patients who have chronic critical illness, operationally defined as those requiring prolonged mechanical ventilation, are markedly increasing in number and commonly experience profound, persistent physical and psychological debilitation. This patient population consumes an extraordinary amount of health care resources attributed to both the acute hospitalization as well as complex post-discharge treatments provided across multiple post-acute care facilities. Currently, the US health care system incentivizes these patient flow dynamics. Health care policy changes addressing post-acute care payment are inevitable. This chapter highlights potential patient, family, physician, and systems targets for current and future interventions, designed to improve quality and reduce costs for this patient population.

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Carlucci, Annalisa, et Paolo Navalesi. Weaning failure in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0103.

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Weaning failure has been defined as failure to discontinue mechanical ventilation, as assessed by the spontaneous breathing trial, or need for re-intubation after extubation, so-called extubation failure. Both events represent major clinical and economic burdens, and are associated with high morbidity and mortality. The most important mechanism leading to discontinuation failure is an unfavourable balance between respiratory muscle capacity and the load they must face. Beyond specific diseases leading to loss of muscle force-generating capacity, other factors may impair respiratory muscle function, including prolonged mechanical ventilation, sedation, and ICU-acquired neuromuscular dysfunction, potentially consequent to multiple factors. The load depends on the mechanical properties of the respiratory system. An increased load is consequent to any condition leading to increased resistance, reduced compliance, and/or occurrence of intrinsic positive-end-expiratory pressure. Noteworthy, the load can significantly increase throughout the spontaneous breathing trial. Cardiac, cerebral, and neuropsychiatric disorders are also causes of discontinuation failure. Extubation failure may depend, on the one hand, on a deteriorated force-load balance occurring after removal of the endotracheal tube and, on the other hand, on specific problems. Careful patient evaluation, avoidance and treatment of all the potential determinants of failure are crucial to achieve successful discontinuation and extubation.

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46

Huyette, Miles Clayton. Mechanical Heating and Ventilation, an Exhaustive Analysis of All Systems. Franklin Classics Trade Press, 2018.

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Mechanical Heating and Ventilation , an Exhaustive Analysis of All Systems. Franklin Classics, 2018.

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Mechanical Heating and Ventilation , an Exhaustive Analysis of All Systems. Franklin Classics, 2018.

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Huyette, Miles Clayton. Mechanical Heating and Ventilation, an Exhaustive Analysis of All Systems. Franklin Classics Trade Press, 2018.

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50

Fertikh, Mounir. Oxygen Delivery Systems And Mechanical Ventilation Made easy for House Officers. Trafford Publishing, 2006.

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