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A A-A DO2, 152–156 Abgs. See Arterial Blood Gases Accelerating

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A A-A DO2, 152–156 Abgs. See Arterial Blood Gases Accelerating Index A A-a DO2, 152–156 ABGs. See Arterial blood gases Accelerating waveform, 123 ACMV. See Volume assist-control mode Acute hypoxemic respiratory failure (AHRF), 424–426 Acute respiratory distress syndrome (ARDS) case study, 523–524 characterization criteria, 248–249 historical aspects, 5–6 pathophysiology diffuse alveolar damage (DAD), 251 Starling equation, 250 primary and secondary, 249 ventilatory strategies airway pressures, 253–254 flow waveforms, 254–255 inspiratory time, 259 inverse ratio ventilation, 259 overdistension, 256–258 PEEP, 255–256 permissive hypercapnia, 261–263 prone ventilation, 263–266 recruitment maneuvers, 260–261 respiratory rate, 254 tidal volumes, 253 ventilation modes, 252–253 Acute respiratory failure (ARF). See Noninvasive ventilation (NIV) Adaptive support ventilation (ASV), 109–110 Adjunctive therapies, 479–504 Adenosine triphosphate (ATP), 171 Adsorptive altelectasis, 326–327 Aerosolized antibiotics, 370–371 527 528 Index Aerosol therapy, 486 Airway humidification. See Humidification, airway Airway occlusion pressure, 399 Airway pressure release ventilation (APRV), 97–98 Airway pressures. See Pressure-time scalar Airway resistance (Raw) calculation, 37, 38 Poiseuille’s law, 35 pulmonary elastance (Pel), 35–36 Alarms apnea, 147 high expired minute volume, 143–144 low airway pressure limit, 146 low expired minute volume activating conditions, 142, 143 airway alarm activation, 141, 142 low oxygen concentration (FIO2), 146 oxygen concentration, 146 power failure, 147 two-minute button, 148 upper airway pressure limit, 144–146 upper oxygen concentration (FIO2), 147 Alveolar dead-space, 40 Alveolar ventilation, 42–43 Anatomical dead-space, 40 Antibiotics aerosolized, 370–371 cycling, 374–375 resistance ESBL, 366 MRSA, 368 multi-drug resistance (MDR), 367 principles, 365 selection, 368–370 topical, 362–363 Apnea alarm, 147 APRV. See Airway pressure release ventilation Arrhythmias, 244, 311–312 Arterial blood gases (ABGs), 159 Arterial oxygen tension A-a DO2, 152–156 oxygen cascade, 149–150 PaO2, 151 PaO2/FIO2 ratio, 151 Index 529 PaO2/PAO2 ratio, 151–152 Arteriovenous oxygen difference, 172–173 Aspiration, 312 Assist control mode, 84 Asthma. See Obstructive lung disease ASV. See Adaptive support ventilation Asynchrony, patient-ventilator, 225 flow asynchrony, 227–238 triggering asynchrony, 226–227 ventilator support level and work of breathing, 223 Automode, 106–107 Auto-PEEP clinical signs, 233, 234 flow-volume loop, 235 pressure-volume loop, 235, 236 measurement, 236–238 B BAL. See Broncho-alveolar lavage technique Barotrauma biotrauma, 321–322 case study, 510 manifestations, 318, 319 pneumomediastinum, 319–320 volutrauma, 320–321 Baseline variables, 78–79 Bilevel positive airway pressure (Bi-PAP), 97, 98 Biofilms, 349–350 Biotrauma, 321–322 Body suit, 442–443 Bohr equation, 45, 46 Broncho-alveolar lavage (BAL) technique, 358–359 Bronchopleural fistula (BPF), 278–279 Bronchopulmonary dysplasia, 333 Bronchospasm, 312Bulbar muscles involvement, 285–286 C Capnography components, 174–175 CPR, 182 mainstream and sidestream sensors, 180–181 PetCO2 factors affecting, 177 530 Index health and disease, 176 vs. PaCO2, 179 sidestream analyzers, 178 Carboxyhemoglobin (CO), 168 Cardiogenic pulmonary edema, 517–518 Cardiopulmonary resuscitation (CPR), 182 Cerebral autoregulation, 245, 246 Cerebral vasoconstriction, 247 Cervical spine injury, 308–309 Circuit, pneumatic 73 Compliance, lung dynamic, 32–34 respiratory system, 31 static, 29–31 Compliance, rate, oxygenation, and pressure (CROP) index, 404 Continuous positive airway pressure (CPAP), 95–97, 415 Control panel, 72 Control variables, 74–75 Cooperativity, 158 COPD exacerbation. See also Obstructive lung disease case study, 505 hypercapnic respitatory failure, 426–427 Cough strength, assessment, 409–410 CO2 transport, 157 CPAP. See Continuous positive airway pressure CPR. See Cardiopulmonary resuscitation Critical delivery of oxygen (DO2 crit), 174 CROP. See Compliance, rate oxygenation, and pressure index Cuff leak, 315–317 Cuirass, 3–4, 443 Cycle variables flow-cycled breath, 77 pressure-cycled breath, 78 time-cycled breath, 78 volume-cycled breath, 76–77 respiratory cycle phases, 74 D Dead-space alveolar, 40 anatomical, 40 physiological, 40–46 Decelerating waveform, 123 Diffuse alveolar damage, 332–333 Index 531 DO2 crit. See Critical delivery of oxygen Dual breath control, 102–103 adaptive support ventilation (ASV) , 109–110 automode, 106–107 interbreath control, 103 intrabreath control, 102–103 mandatory minute ventilation (MMV), 107–108 pressure regulated volume control (PRVC), 103–106 advantages, 105–10 algorithm, 104 disadvantages, 106 modes, 105 volume support (VS), 108–109Dynamic hyperinflation causation mechanism, 316 causes, 317 exhalation problems, 318 functional residual capacity (FRC), 315 treatment strategies, 317 E ECCO2R. See Extracorporeal CO2 removal ECLS. See Extracorporeal life support ECMO. See Extracorporeal membrane oxygenation Endotracheal tube (ET), 19–21 Endotracheal tube obstruction, 313 EPAP. See Expiratory positive airway pressure Epistaxis, 307–308 ESBL. See Extended-spectrum beta-lactamase Esophageal intubation, 309–310 Esophageal perforation, 310 ET. See Endotracheal tube Expiratory asynchrony, 231–238 Expiratory hold and expiratory retard, 79–80 Expiratory valve, 73 Expiratory positive airway pressure (EPAP), 416 Extended-spectrum beta-lactamase (ESBL), 366 Extracorporeal CO2 removal (ECCO2R), 487 Extracorporeal life support (ECLS), 486–488 Extracorporeal membrane oxygenation (ECMO), 486–487 Extubation airway evaluation, 410–411 strength of cough assessment, 409–410 technique, 410 Eye irritation, 431 532 Index F Flail chest, 289–290 Flow asynchrony constant flow-volume-targeted ventilation, 228 expiratory asynchrony auto-PEEP, 233–238 delayed termination, 231–232 premature termination, 232–234 flow and pressure volume loop, 230 flow-time scalar, 229 Flow profile, 122–123 Flow rate, 118–119 Flow-time scalar airflow obstruction, 199, 200 derived information, 197, 198 emphysema, 200 flow waveforms, 196 low compliance, 200, 201 Flow-volume loop airway secretions, 223, 225 auto PEEP, 219, 221 decreased compliance, 221 increased airway resistance, 217–220 pressure-control ventilation, 216, 218 pressure support ventilation (PSV), 216–217, 219 tubing compressibility, 222–224 volume loss, 221–222 volume-targeted ventilation, 215–217 Forced vital capacity (FVC), 12 FRC. See Functional residual capacity Functional residual capacity (FRC), 19 FVC. See Forced vital capacity G Gas exchange monitoring, 149–184 Gastric distension, 430 Gastrointestinal dysfunction, 63 H Haldane effect, 329, 330 Hand-washing, 360–361 Heated humidifiers (HHs), 453 Heat-moisture exchangers (HMEs), 455–456 Helium–oxygen mixtures, 493–494 Index 533 Hemodynamic compromise, 431 Hemodynamic effects of mechanical ventilation, 55–58 Hemoglobin structure, 156, 158 oxygenated and non-oxygenated, 161 Hepatobiliary dysfunction, 62–63 HFJV. See High-frequency jet ventilation HFOV. See High-frequency oscillatory ventilation HFPPV. See High-frequency positive pressure ventilation HFPV. See High-frequency percussive ventilation High expired minute volume alarm, 143–144 High-frequency jet ventilation (HFJV), 482–484 High-frequency oscillatory ventilation (HFOV), 484–485 High-frequency percussive ventilation (HFPV), 485–486 High-frequency positive pressure ventilation (HFPPV), 482 Historical aspects of mechanical ventilation, 1–6 HMEs. See Heat-moisture exchangers Humidification, airway dry air, 451 overcondensation, 452 overheated air, 451–452 isothermic saturation boundary, 449–450 nasal mucosa role, 449 NIV, 456 water losses, 450 Hypercapnic respiratory failure case study, 510–511 COPD exacerbation, 426–427 decompensated obstructive sleep apnea, 427 Hyperoxic hypercarbia, 329–332Hypocapnia, 508 Hypovolemic shock, 244–245 Hypoxemia diffusion defect, 54–55 hypoventilation, 46–49 right to left shunt, 52–53 V/Q mismatch, 50–51 Hypoxemic respiratory failure, 424–426 Hypoxia, tissue, 172 I Indications for mechanical ventilation hypoventilation, 10–11 hypoxia, 9–10 increased work, breathing, 11 534 Index Inspiratory hold, 79 Inspiratory positive airway pressure (IPAP), 416 Interbreath control, 103 Intrabreath control, 102–103 Intracranial pressure, 246 Intermittent mandatory ventilation (IMV). See Synchronized intermittent mandatory ventilation Intrathoracic pressure (ITP), 21, 23 Intubation esophageal, 309–310 right main bronchial, 310–311 endotracheal, 305, 322, 425 Inverse ratio ventilation (IRV), 133, 479–480 IPAP. See Inspiratory positive airway pressure Iron lung. See Tank ventilator Isothermic saturation boundary, 449–450 ITP. See Intrathoracic pressure J Jacket ventilator, 442–443 Jet nebulizers, 466–468 L LaPlace’s law, 492 Laryngeal trauma, 306 Limit variable, 76 Liquid ventilation partial, 496–497 perfluorocarbons, 495 total liquid ventilation (TLV), 496 Low airway pressure limit alarm, 146 Lower inflection point (Pflex), 128 Low expired minute volume alarm activating conditions, 142, 143 airway alarm activation, 141, 142 Low oxygen concentration (FIO2) alarm, 146 pressure-volume loop airway pressures, 204–206 compliance, 208–212 elastic work and resistive work, 211–214 machine breath, 204, 213 PEEP, 206, 208 spontaneous breath, 203–204 transalveolar pressure gradient, 205–207 Index 535 triggering, 206, 207 volume loss, 213–214 scalars flow-time, 196–201 pressure-time, 190–196 volume-time, 200–202 ventilator waveforms, 189 M Mandatory minute ventilation (MMV),
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