Introduction

The Ventilator Book was written as a guide for students, residents, nurses, and respiratory therapists. It was written with the goal of being a quick reference and an easy-to-read overview of mechanical ventilation. Based on feedback from readers, I believe that it has accomplished its purpose.

The Advanced Ventilator Book aims to take the reader to the next level, while preserving the same format and structure that makes The Ventilator Book a useful reference. This is a book designed for clinicians with some experience in caring for critically ill patients who would like some guidance on how to manage cases of severe respiratory failure. I have written it with the assumption that the reader understands the basics of mechanical ventilation and the pathophysiology of critical illness or injury. The first two chapters get back to the basics, with an overview of oxygen delivery and the concept of permissive hypercapnia. Following this are chapters covering the titration of positive end-expiratory pressure; the management of the patient with severe bronchospasm; the use of prone positioning and therapeutic neuromuscular blockade; inhaled nitric oxide and prostacyclin; veno-venous extracorporeal life support; and a chapter on incorporating all of this into a treatment strategy .

One feature of The Ventilator Book was the emphasis on practical use. Many textbooks and articles describe the rationale for a particular mode of ventilation or therapy, but relatively few actually tell the reader how to do it. The Advanced Ventilator Book provides the same step-by-step guidance to help clinicians put these principles into practice.

The Advanced Ventilator Book also continues the original book's emphasis on support and lung protection rather than cure. No magic bullets are promised, as none exist. Mechanical ventilation for patients with severe respiratory failure has great potential to harm, and so the avoidance of preventable injury is stressed with each topic in the book. The bulk of critical care medicine is supportive in nature, and the treatment of acute respiratory failure is no exception.