دانلود کتاب تنفس مکانیکی در نوزادان و کودکان

With so many books on the subject, a reasonable question may be “why another book”? During our careers as clinicians, investigators and educators, we have observed that the healthcare providers are often intimidated by the ventilators as they focus on the machine rather than the altered pathophysiology that is to be addressed in the least injurious fashion while allowing sufficient time for recovery to occur. The ventilator manufacturers do not make it easier by introducing different terminology for similar interventions adding further confusion. We have also observed that nurses, physicians and respiratory therapists have their own areas of attention. We have attempted to provide a common framework based on growth-dependent pulmonary mechanics and underlying pathophysiologic mechanism necessitating all forms of support of the respiratory system. We hope that this framework is an effective tool to understand the underlying pathophysiologic derangements and the therapeutic rationale behind the supportive measures necessary. We also hope that this book will be useful for readers from different disciplines at varying levels of experience, at the bedside as clinicians, in the classrooms as educators and in the academic settings conducting scholarly activities. We begin with traditional, age-old principles of pulmonary mechanics and physiology of gas exchange taught by Julius Comroe and simplified by John West. These are important for any student to build his/her understanding the fundamentals of lung dysfunction. The concepts of static and dynamic processes are explained and mechanisms of airflow in health and disease are described. Importance of clinical examination and physical assessment is emphasized followed by description of monitoring techniques. Within this framework, we present both invasive and non-invasive support of respiration. Every attempt is made to not only direct the reader what to do but also the rationale for why a certain approach is superior in some situations but not others. A separate section on special challenges encountered in the neonatal period is presented. Finally, we describe various case-based approaches in managing respiratory failure.