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E-raamat: Monitoring Mechanical Ventilation Using Ventilator Waveforms

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  • Formaat: PDF+DRM
  • Sari: Medicine
  • Ilmumisaeg: 21-Feb-2018
  • Kirjastus: Springer International Publishing AG
  • Keel: eng
  • ISBN-13: 9783319586557
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Monitoring Mechanical Ventilation Using Ventilator WaveformsSuurem pilt
  • Formaat: PDF+DRM
  • Sari: Medicine
  • Ilmumisaeg: 21-Feb-2018
  • Kirjastus: Springer International Publishing AG
  • Keel: eng
  • ISBN-13: 9783319586557
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This book discusses the interpretation mechanical ventilator waveforms. Each page shows a screenshot from a real patient and explains one or two messages. It starts with basic information about the waveforms and goes on to address passive and spontaneous ventilation, non-invasive ventilation and specific measurements such as pressure-volume curves and esophageal pressure. Step by step, readers learn about advanced monitoring of patient-ventilator synchronisation. This unique teaching approach has been adapted to this topic.

Covering the entire field of mechanical ventilation, it is of particular interest to physicians and respiratory therapist working in emergency departments, anesthesiology, intensive care and respiratory units.

Arvustused

This pocket-sized book describes how to evaluate the interaction of a patient with a ventilator, using physiological tracings generated by the machine. Practitioners using mechanical ventilation with all degrees of sophistication may benefit from this book from senior respiratory therapists. This is a unique and important contribution. The concise presentation takes readers from the basics to recognition of important clinical problems. (David J. Dries, Doody's Book Reviews, May, 2018) The textbook is a concise, well-written attempt to describe multiple aspects of liver transplant for the anesthesiologist. This book is a must-have for any fellow or practitioner engaged in liver transplantation and would be an invaluable tool to introduce rotating residents to the specialty. (Stephen Aniskevich, Anesthesia & Analgesia, Vol. 128 (1), January, 2019)

1 Basics
1(28)
1.1 What Is a Curve?
1(2)
1.2 Which Curves Are Relevant?
3(1)
1.3 What Is a Loop?
4(1)
1.4 Pressure Curve
5(1)
1.5 Flow Curve
6(1)
1.6 Volume Curve
7(1)
1.7 Time Scale
8(1)
1.8 Mandatory and Triggered Breaths
9(1)
1.9 Static Respiratory Mechanics
10(2)
1.10 Equation of Motion in Passive Patients
12(2)
1.11 Equation of Motion for Spontaneously Breathing Patients
14(1)
1.12 Independent and Dependent Variables
15(1)
1.13 Which Curves Should Be Monitored During Inspiration?
16(1)
1.14 Compliance
17(1)
1.15 Static and Dynamic Compliance
18(2)
1.16 Resistance
20(1)
1.17 Dynamic Respiratory Mechanics: Time Constant
21(2)
1.18 Expiratory Time Constant
23(1)
1.19 Clinical Application of the Expiratory Time Constant
24(1)
1.20 Rationale Behind Curve Analysis
25(2)
Suggested Readings
27(2)
2 Controlled Modes
29(30)
2.1 Volume-Controlled Modes
29(18)
2.1.1 Shape of the Pressure Curve
29(2)
2.1.2 Flow Pattern
31(1)
2.1.3 Resistive Component of the Pressure Curve
32(1)
2.1.4 Elastic Component of the Pressure Curve
33(1)
2.1.5 The Pressure Curve for the RC Model
34(1)
2.1.6 Single-Breath Analysis of Overdistension and Recruitment
35(1)
2.1.7 Stress Index
36(1)
2.1.8 Peak Pressure
37(1)
2.1.9 Plateau Pressure
38(1)
2.1.10 End-Inspiratory Occlusion
39(1)
2.1.11 End-Inspiratory Occlusion with Leakage
40(1)
2.1.12 End-Inspiratory Occlusion with Active Effort
41(1)
2.1.13 Ascending Pressure During an End-Inspiratory Occlusion
42(1)
2.1.14 Additional Resistance
43(1)
2.1.15 Increased Peak Pressure
44(1)
2.1.16 Mean Airway Pressure
45(1)
2.1.17 Driving Pressure
46(1)
2.2 Pressure-Controlled Mode
47(10)
2.2.1 Flow Curve
47(1)
2.2.2 Peak Inspiratory Flow
48(1)
2.2.3 Peak Inspiratory Flow Overshoot
49(1)
2.2.4 Shape of Flow Curve
50(1)
2.2.5 Inspiratory Time
51(1)
2.2.6 Inspiratory Time Optimization
52(1)
2.2.7 Plateau Pressure
53(1)
2.2.8 Mean Airway Pressure
54(1)
2.2.9 Driving Pressure
55(2)
Suggested Reading
57(2)
3 Monitoring During Expiration
59(22)
3.1 Which Curves Should Be Monitored During Expiration?
59(2)
3.2 Normal Shape of Expiration
61(1)
3.3 Peak Expiratory Flow
62(1)
3.4 Active Expiration
63(1)
3.5 Shape of Expiratory Flow: Normal
64(1)
3.6 Shape of Expiratory Flow: Decreased Compliance
65(1)
3.7 Shape of Expiratory Flow: Increased Resistance
66(1)
3.8 Shape of Expiratory Flow: Flow Limitation
67(2)
3.9 Secretions
69(1)
3.10 Bi-compartmental Expiration
70(1)
3.11 Tracheal Malacia
71(1)
3.12 End-Expiratory Flow
72(2)
3.13 End-Expiratory Occlusion
74(1)
3.14 AutoPEEP Without Dynamic Hyperinflation
75(1)
3.15 Effect of Bronchodilators
76(2)
3.16 Pressure Curve During Expiration
78(2)
Suggested Readings
80(1)
4 Assisted and Spontaneous Modes
81(26)
4.1 Pressure Support
81(21)
4.1.1 Normal Curves
81(2)
4.1.2 Inspiratory Trigger
83(1)
4.1.3 Trigger Effort
84(1)
4.1.4 Inspiratory Trigger Time
85(1)
4.1.5 Inspiratory Delay Time
86(1)
4.1.6 Ineffective Inspiratory Efforts
87(1)
4.1.7 Cardiac Oscillations
88(1)
4.1.8 Autotriggering
89(1)
4.1.9 Double Triggering
90(1)
4.1.10 Pressure Rise Time
91(1)
4.1.11 Peak Inspiratory Flow
92(1)
4.1.12 Pressure Overshoot
93(1)
4.1.13 Flow Overshoot
94(1)
4.1.14 Shape of Inspiratory Flow
95(1)
4.1.15 Inspiratory Effort
96(1)
4.1.16 Expiratory Trigger Sensitivity
97(1)
4.1.17 Optimal Expiratory Trigger Sensitivity Setting
98(1)
4.1.18 Early Cycling
99(1)
4.1.19 Delayed Cycling
100(1)
4.1.20 Delayed Cycling and Strong Inspiratory Effort
101(1)
4.2 Volume Assist Control
102(3)
4.2.1 Normal Pressure Curve
102(1)
4.2.2 Flow Starvation
103(2)
Suggested Readings
105(2)
5 Noninvasive Ventilation
107(22)
5.1 NIV in Pressure Support Mode
107(2)
5.2 Unintentional Leaks
109(1)
5.3 Leak Rate
110(2)
5.4 Inspiratory Trigger Delay
112(1)
5.5 Autotriggering
113(1)
5.6 Double Triggering
114(1)
5.7 Ineffective Inspiratory Effort
115(1)
5.8 Flow Overshoot
116(1)
5.9 Patient Effort
117(1)
5.10 Leaks and Cycling
118(1)
5.11 Inspiratory Flow Distortion
119(1)
5.12 Early Cycling
120(2)
5.13 Delayed Cycling
122(1)
5.14 Delayed Cycling and Patient Inspiratory Effort
123(1)
5.15 Upper Airway Obstruction
124(1)
5.16 Cheyne-Stokes Respiration
125(2)
Suggested Readings
127(2)
6 Pressure-Volume Loop
129(20)
6.1 Quasi-Static Pressure-Volume Loop
129(2)
6.2 Flow When Performing the PV Loop
131(1)
6.3 PV Loop in a Normal Lung
132(1)
6.4 PV Loop in ARDS
133(1)
6.5 Change in Slope During Inflation
134(2)
6.6 Linear Compliance
136(1)
6.7 Chest-Wall Effect
137(1)
6.8 Change in Slope During Deflation
138(2)
6.9 Hysteresis
140(2)
6.10 Hysteresis in COPD
142(1)
6.11 Assessing the Potential for Recruitment
143(1)
6.12 Recruitment Maneuvers
144(3)
Suggested Readings
147(2)
7 Esophageal Pressure Curve
149
7.1 The Esophageal Pressure Curve in Passive Patients
149(17)
7.1.1 Normal Curve
149(2)
7.1.2 Positioning
151(1)
7.1.3 Occlusion Test in Passive Patient
152(2)
7.1.4 Inflation of the Esophageal Balloon
154(1)
7.1.5 Transalveolar Pressure
155(1)
7.1.6 PTA at End Inspiration
156(1)
7.1.7 PTA at End Expiration
157(1)
7.1.8 Transpulmonary Driving Pressure
158(1)
7.1.9 Transpulmonary Pressure-Volume Loop
159(1)
7.1.10 Airway and Transpulmonary PV Loops
160(2)
7.1.11 Hysteresis
162(1)
7.1.12 Transpulmonary Pressure During Recruitment Maneuvers
163(1)
7.1.13 Increase in Volume During Recruitment Maneuvers
164(1)
7.1.14 Reverse Triggering
165(1)
7.2 Esophageal Pressure Curve in Spontaneously Breathing Patients
166(13)
7.2.1 Normal Curve
166(1)
7.2.2 Occlusion Test in Spontaneous Breathing Patient
167(1)
7.2.3 Transpulmonary Pressure
168(2)
7.2.4 Inspiratory Effort
170(1)
7.2.5 Shape of the Inspiratory Effort
171(1)
7.2.6 Inspiratory Trigger Synchronization
172(1)
7.2.7 Ineffective Inspiratory Efforts
173(1)
7.2.8 Autotriggering
174(1)
7.2.9 Relaxation of Inspiratory Muscles
175(1)
7.2.10 Expiratory Trigger Synchronization
176(1)
7.2.11 Passive Inflation and Active Expiratory Effort
177(2)
Suggested Readings
179
Dr. Jean-Michel Arnal is an anesthesiologist specialized in intensive care medicine. He is senior intensivist in the Hopital Sainte Musse, Toulon, France; he also works as a medical research manager at the research department of Hamilton Medical, Switzerland. After studying medicine in Paris, he specialized in anaesthesiology, medical intensive care and hyperbaric medicine in Marseille. He has established a home ventilation unit and a mechanical-ventilation training center in Toulon. Dr. Arnal has published around 50 articles in international, peer-reviewed journal. His primary interests include mechanical ventilation, ARDS, closed loop ventilation, non-invasive ventilation, and home long-term ventilation. He teaches at international workshop on mechanical ventilation and is a speaker at international meetings. Dr. Arnal is an expert in mechanical ventilation, a respected researcher and speaker at international conferences and has been teaching this topic for many years.





Dr. Robert L. Chatburn is a professor at the Department of Medicine, Lerner College of Medicine, Case Western Reserve University and a fellow of the American Association for Respiratory Care. He is currently the clinical research manager, at the Respiratory Institute and director of the Simulation Fellowship, Education Institute at the Cleveland Clinic. Previously he was the technical director of respiratory care at Rainbow Babies & Children Hosptial/University Hospitals for 20 years. He is the author of 11 textbooks and over 300 publications in medical journals. He is an associate editor of the Respiratory Care Journal and is an internationally recognized research scientist and authority on mechanical ventilation and pediatric respiratory care.
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