ERS Practical Handbook of Invasive Mechanical Ventilation

Invasive ventilation is a frequently used lifesaving intervention in critical care. The ERS Practical Handbook of Invasive Mechanical Ventilation provides a concise “why and how to” guide to invasive ventilation, ensuring that caregivers can not only apply invasive ventilation, but obtain a thorough understanding of the underlying principles ensuring that they and their patients gain the most value from this intervention. Editors Leo Heunks and Marcus J. Schultz have brought together leading clinicians and researchers in the field to provide an easy-to-read guide to all aspects of invasive ventilation. Topics covered include: underlying physiology, equipment, invasive ventilation in specific diseases, patient monitoring, supportive therapy and rescue strategies, inhalation therapy during invasive ventilation, weaning from invasive ventilation and technical aspects of the ventilator. This Practical Handbook is a valuable reference and training resource for all invasive ventilation practitioners. • User-friendly format, with key point summaries • A focus on practical aspects and problem solving • Online multiple-choice questions to enable self-assessment Leo Heunks is pulmonologist-intensivist and Professor of Experimental Intensive Care Medicine at the Amsterdam UMC, location VUmc, Amsterdam, the Netherlands. Marcus J. Schultz is Honorary Researcher of Nuffield College, Oxford University, Oxford, UK, and the Mahidol–Oxford Research Unit (MORU), Mahidol University, Bangkok, Thailand, and Professor of Experimental Intensive Care at the University of Amsterdam UMC, location AMC, Amsterdam, the Netherlands.

Table of Contents:
1. Physiology Mechanisms of hypoxaemia and hypercapnia 1 Respiratory mechanics 8 Effects of invasive ventilation on the lungs 16 Effects of invasive ventilation on the respiratory muscles 26 2. Getting the basics right: artificial airway and ventilator modes Artificial airways 33 Controlled modes 43 Partially supported modes 53 Proportional modes 62 Automated modes 74 3. Getting the basics right: mechanical ventilation in specific diseases Invasive ventilation in ARDS 81 Invasive ventilation in obstructive airway disease 88 Invasive ventilation in interstitial lung diseases 95 4. Monitoring the ventilated patient Monitoring oxygenation 100 Monitoring ventilation 105 Monitoring respiratory mechanics 111 Monitoring breathing effort 119 Electrical impedance tomography 129 Monitoring lung aeration: lung ultrasound 136 Monitoring respiratory muscles: respiratory muscle ultrasound 147 Monitoring lung pathology: chest radiography and computed tomography 154 Monitoring patient–ventilator interaction 159 5. Supportive therapy and rescue strategies in hypoxaemic failure Extracorporeal lung support 171 Prone position in ARDS 177 Recruitment manoeuvres 185 Pulmonary vasoactive drugs 195 6. Inhalation therapy in ventilated patients Inhalation therapy in ventilated patients 201 7. Weaning from mechanical ventilation Weaning definition and outcome 207 Weaning protocols and automatic modes 214 Failure to wean and causes for difficult weaning 221 Weaning: a practical approach 227 Tracheostomy 235 Physiotherapy and speech therapy in ventilated patients 242 8. Technical aspects of the ventilator Technical aspects of the ventilator 252