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SECTION I TECHNICAL ASPECTS OF MECHANICAL VENTILATION |
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1 | (158) |
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Classification of Mechanical Ventilators |
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1 | (48) |
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2 | (1) |
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2 | (1) |
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3 | (1) |
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3 | (1) |
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3 | (39) |
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10 | (2) |
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12 | (10) |
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22 | (2) |
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24 | (7) |
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31 | (4) |
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35 | (7) |
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42 | (7) |
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43 | (1) |
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43 | (1) |
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43 | (6) |
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Modes of Ventilator Operation |
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49 | (40) |
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Pressure Control Versus Volume Control |
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50 | (1) |
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Pressure Target Versus Volume Targe |
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50 | (1) |
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51 | (20) |
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Continuous Mandatory Ventilation |
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51 | (1) |
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Assist-Control Ventilation |
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52 | (3) |
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Assisted Mechanical Ventilation |
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55 | (3) |
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Intermittent Mandatory Ventilation |
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58 | (1) |
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Synchronized Intermittent Mandatory Ventilation |
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59 | (1) |
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Pressure Support Ventilation |
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60 | (4) |
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Continuous Positive Airway Pressure |
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64 | (2) |
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Airway Pressure Release Ventilation |
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66 | (2) |
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Pressure Control Inverse Ratio Ventilation |
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68 | (1) |
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Mandatory Minute Ventilation |
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69 | (2) |
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71 | (1) |
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71 | (3) |
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Dual Control Within a Breath |
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71 | (2) |
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Dual Control Breath-to-Breath-Pressure-Limited, Flow-Cycled Ventilation |
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73 | (1) |
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Dual Control Breath-to-Breath-Pressure-Limited, Time-Cycled Ventilation |
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73 | (1) |
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74 | (2) |
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Adaptive Support Ventilation |
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76 | (2) |
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Adaptive Tidal Volume Support |
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78 | (1) |
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Automatic Tube Compensation |
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79 | (1) |
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Proportional Assist Ventilation |
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80 | (2) |
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82 | (7) |
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The Patient-Ventilator Interface: Ventilator Circuit, Airway Care, and Suctioning |
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89 | (22) |
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90 | (2) |
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90 | (1) |
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91 | (1) |
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Care of the Artificial Airway |
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92 | (8) |
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92 | (4) |
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96 | (1) |
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Special Endotracheal Tubes |
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97 | (1) |
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Silver-Coated or Silver-Impregnated Endotracheal Tubes |
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97 | (1) |
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Subglottic Suction Endotracheal Tubes |
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97 | (1) |
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98 | (1) |
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Management of the Endotracheal Tube Cuff |
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98 | (1) |
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99 | (1) |
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100 | (3) |
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101 | (1) |
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Use of Saline Instillation |
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102 | (1) |
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Complications of Suctioning |
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102 | (1) |
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Patient-Ventilator System Check |
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103 | (8) |
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Humidification and Aerosol Therapy |
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111 | (35) |
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112 | (2) |
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114 | (1) |
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115 | (1) |
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Types of High-Flow Humidifiers |
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116 | (1) |
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116 | (3) |
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Characteristics of Artificial Noses |
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119 | (2) |
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119 | (1) |
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119 | (1) |
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120 | (1) |
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120 | (1) |
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120 | (1) |
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Choosing the Right Passive Humidifier |
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121 | (1) |
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Use of Humidification Devices During Mechanical Ventilation |
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121 | (2) |
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Active Hygroscopic Heat and Moisture Exchangers |
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123 | (1) |
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Heat and Moisture Exchanger Booster |
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124 | (1) |
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Aerosol Therapy During Mechanical Ventilation |
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124 | (8) |
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124 | (1) |
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Types of Aerosol Generators |
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125 | (3) |
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Choosing an Aerosol Delivery System |
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128 | (1) |
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Aerosol Delivery During Mechanical Ventilation |
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128 | (2) |
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Monitoring Bronchodilator Efficacy |
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130 | (2) |
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Recommendations for Aerosol Therapy in Mechanically Ventilated Patients |
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132 | (1) |
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Aerosolized Pharmacologic Agents |
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132 | (14) |
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132 | (3) |
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135 | (1) |
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136 | (1) |
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137 | (9) |
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Ventilator Monitors and Displays |
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146 | (13) |
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Pressure and Flow Sensors |
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147 | (4) |
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147 | (1) |
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148 | (1) |
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Output from Pressure/Flow/Volume Sensors |
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149 | (1) |
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149 | (2) |
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Gas Analyzers and Gas Exchange Monitors |
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151 | (1) |
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151 | (1) |
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Future Sensors and Monitors |
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151 | (2) |
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153 | (6) |
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Levels of Events and Alarm Requirements |
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153 | (2) |
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155 | (4) |
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159 | (58) |
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Respiratory System Mechanics |
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159 | (12) |
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159 | (3) |
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Lung Inflation and Respiratory System Mechanics: Equation of Motion |
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162 | (3) |
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162 | (2) |
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164 | (1) |
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165 | (2) |
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Interaction of Respiratory System Mechanics with Ventilator Settings |
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167 | (4) |
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Mechanical Determinants of Delivered Ventilation |
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167 | (4) |
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Alveolar-Capillary Gas Transport |
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171 | (11) |
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Steady-State Alveolar-Capillary Pressure Gradients |
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171 | (2) |
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Ventilation-Perfusion Matching |
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173 | (1) |
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Positive Pressure Ventilation Effects on Ventilation-Perfusion Matching |
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174 | (4) |
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Inspiratory and Expiratory Positive Pressure |
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174 | (3) |
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Inspiratory Flow Pattern and Inspiratory-Expiratory Time Relationship |
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177 | (1) |
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Intrathoracic Pressures and Perfusion |
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178 | (1) |
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Alveolar-Capillary Gas Transport in the Context of Overall Oxygen Delivery |
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178 | (4) |
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Patient-Ventilator Interactions |
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182 | (16) |
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Determinants of Spontaneous Ventilation |
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183 | (2) |
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Respiratory Control System |
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183 | (1) |
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184 | (1) |
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Patient-Ventilator Interactions |
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185 | (8) |
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185 | (1) |
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Ventilator-Related Factors |
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186 | (7) |
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193 | (5) |
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Cardiopulmonary Interactions |
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198 | (8) |
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Mechanical Forces During Ventilation |
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199 | (1) |
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199 | (1) |
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Ventricular Interdependence |
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199 | (1) |
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Pulmonary Vascular Resistance |
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200 | (1) |
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Pulmonary Vascular Capacitance |
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200 | (1) |
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200 | (1) |
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Stress on Abdominal Vessels |
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200 | (1) |
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Clinical Applications: Transient Effects |
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200 | (1) |
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200 | (1) |
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Respiratory Changes in Pulse Pressure |
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201 | (1) |
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Clinical Applications: Steady-State Effects |
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201 | (5) |
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201 | (2) |
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203 | (3) |
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Ventilator-Induced Lung Injury |
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206 | (11) |
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Alveolar Rupture and Extra-Alveolar Air |
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207 | (1) |
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Stretch-Induced Lung Injury |
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208 | (4) |
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Experimental and Mechanistic Evidence for VILI |
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208 | (3) |
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Clinical Studies Providing Evidence for VILI |
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211 | (1) |
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212 | (5) |
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SECTION III ADJUNCTIVE THERAPY |
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217 | (70) |
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217 | (18) |
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Malnutrition in the Mechanically Ventilated Patient |
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218 | (1) |
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218 | (1) |
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219 | (1) |
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220 | (1) |
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221 | (1) |
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Performance of Indirect Calorimetry |
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222 | (3) |
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Design of the Nutrition Support Regimen |
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225 | (4) |
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Monitoring Response and Patient Tolerance |
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229 | (1) |
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230 | (5) |
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Sedation, Analgesia, and Neuromuscular Blockade |
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235 | (17) |
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237 | (3) |
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Rationale for Pain Management |
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237 | (1) |
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237 | (1) |
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238 | (2) |
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240 | (1) |
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240 | (1) |
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240 | (1) |
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241 | (4) |
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Rationale for Sedation Management |
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241 | (1) |
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241 | (1) |
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242 | (1) |
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243 | (2) |
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245 | (3) |
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Drugs Used for Neuromuscular Blockade |
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245 | (2) |
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247 | (1) |
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248 | (4) |
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252 | (14) |
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Effects of Posture and Position on Healthy Patients |
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253 | (3) |
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253 | (1) |
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Regional Pleural Pressures |
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253 | (1) |
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254 | (1) |
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255 | (1) |
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Distribution of Ventilation |
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256 | (1) |
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Distribution of Perfusion |
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256 | (1) |
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Ventilation-Perfusion (V/Q) Relationships |
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256 | (1) |
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Effects of Posture and Position on Patients with Respiratory Disease |
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256 | (10) |
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256 | (1) |
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Obstructive Airway Disease |
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257 | (1) |
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258 | (1) |
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Acute Respiratory Distress Syndrome |
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258 | (8) |
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Ventilator-Associated Pneumonia |
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266 | (21) |
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Incidence and Risk Factors |
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266 | (1) |
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Morbidity, Mortality, and Cost |
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267 | (1) |
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268 | (2) |
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269 | (1) |
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Respiratory Therapy Equipment |
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269 | (1) |
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270 | (1) |
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270 | (2) |
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272 | (2) |
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Clinical Features and Chest X-Ray |
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272 | (1) |
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Qualitative Culture Techniques |
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273 | (1) |
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Quantitative Culture Techniques |
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273 | (1) |
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274 | (3) |
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274 | (1) |
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Pharmacologic Consideration |
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275 | (1) |
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De-Escalation and Specific Therapy |
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276 | (1) |
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276 | (1) |
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277 | (1) |
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277 | (10) |
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SECTION IV CLINICAL APPLICATIONS |
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287 | (164) |
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Management of Parenchymal Lung Injury |
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287 | (10) |
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Pathophysiology of Parenchymal Lung Injury |
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288 | (1) |
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Goals of Ventilatory Support |
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288 | (1) |
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Mechanical Ventilation Strategies |
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289 | (3) |
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289 | (1) |
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Frequency-Tidal Volume Settings |
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290 | (1) |
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Positive End-Expiratory Pressure and Inspired Oxygen Concentration |
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291 | (1) |
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Novel Approaches to Lung Protection in Parenchymal Lung Injury |
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292 | (1) |
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Airway Pressure Release Ventilation |
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293 | (1) |
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High-Frequency Ventilation |
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293 | (1) |
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Other Considerations in Managing Parenchymal Lung Injury |
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293 | (1) |
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Outcome of Parenchymal Lung Injury |
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293 | (4) |
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Management of Obstructive Airway Disease |
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297 | (9) |
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Pathophysiology of Obstructive Airway Diseases |
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297 | (1) |
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Goals of Ventilatory Support |
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298 | (1) |
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Mechanical Ventilation Strategies |
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298 | (5) |
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298 | (2) |
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Tidal Volume/Frequency/Inspiratory Time |
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300 | (1) |
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Positive End-Expiratory Pressure/Inspired Oxygen Concentration |
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301 | (1) |
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Other Considerations in Ventilatory Management |
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302 | (1) |
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Outcomes of Respiratory Failure in Obstructed Airway Disease |
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303 | (3) |
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Unique Patient Populations |
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306 | (11) |
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307 | (2) |
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Pathophysiology and Unique Features |
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307 | (1) |
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307 | (2) |
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309 | (1) |
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Pathophysiology and Unique Features |
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309 | (1) |
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309 | (1) |
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310 | (3) |
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310 | (1) |
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Perioperative Care of Transplant Recipients |
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311 | (2) |
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313 | (1) |
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Pathophysiology and Unique Features |
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313 | (1) |
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313 | (1) |
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313 | (1) |
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Perioperative Respiratory Failure |
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313 | (1) |
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Pathophysiology and Unique Features |
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313 | (1) |
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313 | (1) |
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314 | (3) |
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Discontinuing Mechanical Ventilation |
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317 | (8) |
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Considering Ventilator Discontinuation |
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318 | (1) |
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Assessing the Potential for Discontinuation |
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318 | (1) |
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Next Steps for Patients With Successful Spontaneous Breathing Trial |
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319 | (1) |
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Managing the Not-Yet-Ready-to-Be Discontinued Patient |
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320 | (1) |
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The Impact of Newer Feedback Controllers on Discontinuation |
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321 | (1) |
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Approaches for the Difficult-to-Wean Patient |
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322 | (3) |
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Prolonged Mechanical Ventilation |
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325 | (14) |
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Prolonged Mechanical Ventilation |
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326 | (1) |
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326 | (2) |
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326 | (1) |
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327 | (1) |
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Ventilator-Dependent Patients |
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327 | (1) |
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Predicting the Need for PMV |
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328 | (1) |
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Reducing the Likelihood of PMV |
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328 | (1) |
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Timing for Tracheostomy Placement |
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329 | (2) |
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331 | (1) |
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331 | (1) |
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331 | (1) |
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331 | (1) |
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331 | (1) |
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Quality of Life and Functional Status |
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331 | (1) |
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332 | (1) |
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Most Effective Way to Wean PMV Patients |
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332 | (1) |
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Predicting Weaning Success |
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333 | (1) |
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Interventions to Improve PMV Outcomes |
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333 | (3) |
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Post---Acute Care Facilities and Respiratory Care Units in PMV Care |
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335 | (1) |
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Palliative Care in the PMV Population |
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335 | (1) |
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336 | (3) |
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Mechanical Ventilation During Transport and Cardiopulmonary Resuscitation |
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339 | (27) |
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Ventilation During Cardiopulmonary Resuscitation |
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340 | (1) |
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Standards for Ventilation and Devices |
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340 | (1) |
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Lung Compliance After Cardiac Arrest |
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340 | (1) |
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Techniques of Emergency Ventilation |
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341 | (5) |
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Expired Air Resuscitation |
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341 | (1) |
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342 | (1) |
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342 | (1) |
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343 | (1) |
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344 | (2) |
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346 | (3) |
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346 | (1) |
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Bag-Valve Device Performance |
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347 | (1) |
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347 | (1) |
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Delivered Oxygen Concentration |
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348 | (1) |
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Nonrebreathing Valve Performance |
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348 | (1) |
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Oxygen-Powered Breathing Devices |
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349 | (3) |
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349 | (1) |
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350 | (1) |
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Ventilator-to-Mask Ventilation |
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350 | (2) |
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Impedence Threshold Device |
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352 | (1) |
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Transport of the Mechanically Ventilated Patient |
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352 | (14) |
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352 | (1) |
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352 | (1) |
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353 | (1) |
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Characteristics of a Ventilator for Intrahospital Transport |
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354 | (3) |
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Physiologic Effects and Risks of Transport |
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357 | (9) |
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Noninvasive Mechanical Ventilation |
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366 | (26) |
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Rationale for the Use of Noninvasive Ventilation |
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367 | (1) |
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Indications for Noninvasive Ventilation: Acute Applications |
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367 | (2) |
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Best Established Indications |
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367 | (2) |
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Indications Supported by Weaker Evidence |
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369 | (1) |
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Other Obstructive Diseases |
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369 | (1) |
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369 | (1) |
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Postoperative Respiratory Failure/ Insufficiency |
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370 | (1) |
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370 | (1) |
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Other Acute Applications of Noninvasive Ventilation |
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370 | (1) |
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Selection Guidelines for Noninvasive Ventilation in Acute Respiratory Failure |
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370 | (2) |
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Determinants of Success/Failure |
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370 | (1) |
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371 | (1) |
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Long-Term Applications of Noninvasive Ventilation |
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372 | (1) |
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Restrictive Thoracic Disease |
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372 | (1) |
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Chronic Obstructive Pulmonary Disease |
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372 | (1) |
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373 | (1) |
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373 | (1) |
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Contraindication to Long-Term Noninvasive Ventilation |
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373 | (1) |
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Techniques and Equipment for Noninvasive Ventilation |
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374 | (7) |
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Noninvasive Positive-Pressure Ventilation |
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374 | (1) |
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375 | (3) |
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Ventilators for Positive-Pressure Noninvasive Ventilation |
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378 | (3) |
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Application of Noninvasive Positive-Pressure Ventilation |
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381 | (5) |
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381 | (1) |
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382 | (1) |
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Adaptation and Monitoring |
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383 | (1) |
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383 | (1) |
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Common Problems and Possible Remedies |
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|
384 | (2) |
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386 | (6) |
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Modifications on Conventional Ventilation Techniques |
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|
392 | (15) |
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Airway Pressure Release Ventilation |
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393 | (1) |
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Description and Rationale |
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|
393 | (1) |
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394 | (1) |
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394 | (1) |
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Independent Lung Ventilation |
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|
394 | (3) |
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Description and Rationale |
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|
394 | (3) |
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|
397 | (1) |
|
|
|
397 | (1) |
|
Proportional Assist Ventilation |
|
|
397 | (3) |
|
Description and Rationale |
|
|
397 | (1) |
|
|
|
398 | (2) |
|
|
|
400 | (1) |
|
Tracheal Gas Insufflation |
|
|
400 | (2) |
|
Description and Rationale |
|
|
400 | (1) |
|
|
|
401 | (1) |
|
|
|
401 | (1) |
|
Modifications for Nuclear Magnetic Scanners and Hyperbaric Chambers |
|
|
402 | (5) |
|
|
|
402 | (1) |
|
Hyperbaric Chamber---Compatible Equipment |
|
|
402 | (5) |
|
High-Frequency Ventilation |
|
|
407 | (11) |
|
|
|
|
|
|
|
408 | (3) |
|
|
|
408 | (2) |
|
|
|
410 | (1) |
|
Mechanism of Gas Transport |
|
|
411 | (1) |
|
|
|
412 | (2) |
|
|
|
414 | (1) |
|
|
|
414 | (4) |
|
Extracorporeal Techniques for Cardiopulmonary Support |
|
|
418 | (11) |
|
|
|
|
|
History of Extracorporeal Life Support |
|
|
418 | (1) |
|
Patient Selection and Criteria for Extracorporeal Life Support |
|
|
419 | (2) |
|
Types of Extracorporeal Life Support |
|
|
421 | (2) |
|
Venoarterial Extracorporeal Life Support |
|
|
421 | (1) |
|
Venovenous Extracorporeal Life Support |
|
|
422 | (1) |
|
Complications Associated With Extracorporeal Life Support |
|
|
423 | (1) |
|
Patient Management During Extracorporeal Life Support |
|
|
423 | (1) |
|
Ventilator and Respiratory Care |
|
|
423 | (1) |
|
|
|
424 | (1) |
|
|
|
424 | (1) |
|
|
|
424 | (1) |
|
Current Status of Extracorporeal Life Support and Outcome in Pediatrics |
|
|
424 | (1) |
|
Extracorporeal Life Support Technology for Adult Respiratory Failure |
|
|
424 | (2) |
|
|
|
426 | (3) |
|
Heliox and Inhaled Nitric Oxide |
|
|
429 | (22) |
|
|
|
|
|
429 | (8) |
|
|
|
429 | (2) |
|
|
|
431 | (4) |
|
Delivery Systems for Heliox |
|
|
435 | (2) |
|
|
|
437 | (14) |
|
|
|
437 | (1) |
|
Selective Pulmonary Vasodilation |
|
|
438 | (1) |
|
|
|
439 | (1) |
|
Toxicity and Complications of Inhaled Nitric Oxide |
|
|
439 | (1) |
|
Delivery Systems for Inhaled Nitric Oxide |
|
|
440 | (11) |
| Appendix 1 Mechanical Ventilation Case Studies |
|
451 | (16) |
|
|
| Appendix 2 Assessment Question Answers |
|
467 | (6) |
| Glossary |
|
473 | |
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