Mechanical ventilation is an integral part of the care of many critically ill patients. It is also provided at sites outside the ICU and outside the hospital, including long-term acute care hospitals and the home. A thorough understanding of the essentials of mechanical ventilation is requisite for respiratory therapists and critical care physicians. A general knowledge of the principles of mechanical ventilation is also required of critical care nurses, mid-level providers, hospitalists, and primary care physicians whose patients occasionally require ventilatory support.
This book is intended to be a practical guide to adult mechanical ventilation. We have written this book from our perspective of nearly 100 years of experience as clinicians, educators, researchers, and authors. We have made every attempt to keep the topics current and with a distinctly clinical focus. We have reviewed every word and updated the content as necessary. We have added new content such as mechanical ventilation of the obese patient and advanced monitoring procedures. Concepts such as driving pressure are included. We have checked the content against recently published clinical practice guidelines. As in the previous editions, we have kept the chapters short, focused, and practical.
Like previous editions, the book is divided into four parts. Part 1, Principles of Mechanical Ventilation, describes basic principles of mechanical ventilation and then continues with issues such as indications for mechanical ventilation, appropriate physiologic goals, and liberation from mechanical ventilation. Part 2, Ventilator Management, gives practical advice for ventilating patients with a variety of diseases. Part 3, Monitoring During Mechanical Ventilation, discusses blood gases, hemodynamics, mechanics, and waveforms. In the final part, Topics Related to Mechanical Ventilation, we discuss issues such as airway management, aerosol delivery, and extracorporeal life support.
This is a book about mechanical ventilation and not mechanical ventilators per se. We do not describe the operation of any specific ventilator (although we do discuss some modes specific to some ventilator types). We have tried to keep the material in this book generic and it is, by and large, applicable to any adult mechanical ventilator. We do not cover issues related to pediatric and neonatal mechanical ventilation. Because these topics are adequately covered in pediatric and neonatal respiratory care books, we have limited the focus of this book to adult mechanical ventilation. Although we provide a short list of suggested readings at the end of each chapter, we have specifically tried to make this a practical book and not an extensive reference book.
This book is written for all clinicians caring for mechanically ventilated patients. We believe that it is unique and hope you will enjoy reading it as much as we have enjoyed writing it.
Dean R. Hess, PhD, RRT
Robert M. Kacmarek, PhD, RRT