Applied Respiratory Physiology

Applied Respiratory Physiology, Third Edition focuses on the applications of respiratory physiology and is designed to bridge the gap between applied respiratory physiology and the treatment of patients. This book is divided into two parts; the first of which is confined to general principles and the second deals with the various applied situations. This text is comprised of 29 chapters. After giving a general introduction to human respiratory physiology, including the functional anatomy of the respiratory tract, this book turns to the topic of the elastic resistance afforded by lungs and chest wall, along with its effect on the resting end-expiratory lung volume or functional residual capacity. The role of anesthesia in the control of breathing and the relative distribution of ventilation and perfusion are then examined. The section on artificial ventilation covers the techniques of ventilation and extracorporeal gas exchange. The reader is also introduced to special forms of lung pathology that have a major effect on lung function, including the adult respiratory distress syndrome, pulmonary oedema, embolus, and collapse. Sleep, smoking, diving, and drowning are also examined in this book. In addition, this text provides substantial coverage of exercise, high altitude, children, and neonates. This book will be of interest to clinicians and practitioners of applied respiratory physiology.

Table of Contents:
Foreword to the First EditionPreface to the First EditionPreface to the Third EditionPart I Basic Principles 1 Functional Anatomy of the Respiratory Tract Mouth and Pharynx The Larynx The Trachobronchial Tree The Alveoli The Pulmonary Vasculature 2 Elastic Forces and Lung Volumes Elastic Recoil of the Lungs Elastic Recoil of the Thoracic Cage Pressure/Volume Relationships of the Lung plus Thoracic Cage Lung Volumes Principles of Measurement of Compliance Principles of Measurement of Lung Volumes 3 Resistance to Gas Flow and Airway Closure Laminar Flow Turbulent Flow Threshold Resistors Minor Sources of Resistance to Gas Flow Increased Airway Resistance Causes of Increased Airway Resistance Compensation for Increased Resistance to Breathing Principles of Measurement of Flow Resistance 4 Control of Breathing The origin of the Respiratory Rhythm Motor Pathways Concerned in Breathing Chemical Control of Breathing Reflex Control of Breathing Breath Holding Ventilatory Response to Loaded Breathing Outline of Methods of Assessment of Factors in Control of Breathing 5 Pulmonary Ventilation Mechanisms of Breathing The Work of Breathing The Minute Volume of Pulmonary Ventilation Measurement of Ventilation Measurement of Ventilatory Capacity 6 The Pulmonary Circulation Pulmonary Blood Volume Pulmonary Vascular Pressures Pulmonary Blood Flow Pulmonary Vascular Resistance Principles of Measurement of the Pulmonary Circulation 7 Distribution of Pulmonary Ventilation and Perfusion Distribution of Ventilation Distribution of Perfusion Ventilation in Relation to Perfusion Dead Space The Concept of Venous Admixture Principles of Assessment of Distribution of Ventilation and Pulmonary Blood Flow 8 Diffusion and Alveolar/Capillary Permeability Fundamentals of the Diffusion Process Diffusion of Oxygen within the Lungs Diffusion of Carbon Monoxide within the Lungs Diffusion of Carbon Dioxide within the Lungs Diffusion of 'Inert' Gases within the Lungs Diffusion of Gases in the Tissues Alveolar/Capillary Permeability Principles of Methods of Measurement of Carbon Monoxide Diffusing Capacity 9 Carbon Dioxide Carriage of Carbon Dioxide in Blood Transfer of Carbon Dioxide Across Cell Membranes Factors Influencing the Carbon Dioxide Tension in the Steady State Causes of Hypocapnia (Respiratory Alkalosis) Causes of Hypercapnia (Respiratory Acidosis) Carbon Dioxide Stores and the Unsteady State Apnoeic Mass-Movement Oxygenation (Formerly Known as Diffusion Respiration) Therapeutic Uses of Carbon Dioxide Outline of Methods of Measurement of Carbon Dioxide 10 Oxygen The Role of Oxygen in the Cell The Oxygen Cascade The Carriage of Oxygen in the Blood The 'Normal' Arterial Oxygen Tension Oxygen Stores and the Steady State Control of the Inspired Oxygen Concentration Cyanosis Principles of Measurement of Oxygen Levels 11 Non-Respiratory Functions of the Lung Filtration Oxidative Metabolism of the Lung Protease Transport System Synthesis of Surfactant Processing of Hormones and Other Vasoactive Compounds Handling of Foreign Substances by the Lungs ConclusionPart II The Applications 12 Respiratory Aspects of Exercise Levels of Exercise Oxygen Consumption Anaerobic Metabolism Response of the Oxygen Delivery System Control of Ventilation 13 Respiratory Aspects of Sleep Normal Sleep The Sleep Apnoea Syndrome The Postoperative Period Relationship to Sudden Infant Death Syndrome (SIDS) 14 Respiratory Aspects of High Altitude Acute Exposure to Altitude Acute Mountain Sickness Adaptation to Altitude Exercise at High Altitude 15 Respiratory Aspects of High Pressure and Diving Exchange of Oxygen and Carbon Dioxide Effects Attributable to the Composition of the Inspired Gas Special Circumstances of Exposure to Pressure Avoidance of Exposure of Man to Pressure 16 Drowning Drowning without Aspiration Aspiration of Fresh Water Sea Water Drowning Other Material Contaminating the Lungs Tests of Drowning The Role of Hypothermia Principles of Treatment of Near-Drowning 17 Smoking Smoking and Lung Function Constituents of Tobacco Smoke Individual Smoke Exposure Respiratory Effects of Smoking 18 Respiration in Neonates and Children The Lungs Before Birth Events at Birth Neonatal Lung Function Development of Lung Function during Childhood Respiratory Distress Syndrome Artificial Ventilation of the Neonate and Young Child 19 Respiratory Aspects of Anesthesia Control of Breathing Pattern of Contraction of Respiratory Muscles Changes in Lung and Trunk Volumes Consequences of the Change in FRC Metabolic Rate Gas Exchange Minute Volume of Ventilation The Three-Compartment Model of Gas Exchange Effect of Hypoxic Pulmonary Vasoconstriction Special Conditions Arising during Anaesthesia 20 Ventilatory Failure Pattern of Changes in Arterial Blood Gas Tensions Causes of Failure of Ventilation Relationship between Rentilatory Capacity and Ventilatory Failure Breathlessness Treatment of Ventilatory Failure 21 Artificial Ventilation Methods Used for Resuscitation Intermittent Positive Pressure Ventilation (IPPV) Special Techniques for IPPV Interaction Between Patient and Ventilator Positive EndEexpiratory Pressure (PEEP) Negative (Subatmospheric) End-Expiratory Pressure (NEEP) Weaning 22 Extracorporeal Gas Exchange Factors in Design Types of Extracorporeal Gas Exchangers Damage to Blood Prolonged Extracorporeal Oxygenation for Respiratory Failure Extracorporeal Removal of Carbon Dioxide 23 Pulmonary Oedema Anatomical Factors Stages of Pulmonary Oedema The Mechanism of Pulmonary Oedema Aetiology Pathophysiology Physiological Principles of Treatment Clinical Measurement 24 Pulmonary Collapse and Atelectasis Loss of Forces Opposing Retraction of the Lung Absorption of Trapped Gas The Effect of Collapse Diagnosis of Pulmonary Collapse Treatment 25 Pulmonary Embolism Air Embolism Thromboembolism Fat Embolism 26 Adult Respiratory Distress Syndrome Definition Clinical Course Predisposing Conditions and Risk Factors Incidence and Mortality Histopathology Pathophysiology Mechanisms of Causation of ARDS Principles of Management Problems of Research into ARDS 27 The Effects of Changes in the Carbon Dioxide Tension Effects upon the Nervous System Effects upon the Respiratory System Effects upon the Circulatory System Effect upon the Kidney Effect on Blood Electrolyte Levels Effect upon Drug Action Bedside Recognition of Hypercapnia 28 Hypoxia Biochemical Changes in Hypoxia PO2 Levels and Hypoxia Compensatory Mechanisms in Hypoxia Organ Survival Times 29 Hyperoxia and Oxygen Toxicity Hyperoxia Hyperbaric Oxygenation Oxygen Toxicity Clinical Oxygen Toxicity Other Hazards of OxygenAppendix A Physical Quantities and Units of MeasurementAppendix B The Gas LawsAppendix C Conversion Factors for Gas VolumesAppendix D Symbols, Abbreviations and DefinitionsAppendix E Nomograms and Correction ChartsAppendix F The Exponential Function The Tear-Away Exponential Function The Wash-out or Die-Away Exponential Function The Wash-in Exponential FunctionReferences and Further ReadingIndex