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Mechanical ventilation is an integral part of the care of many critically ill patients. It is also provided at sites outside the ICU and outside the hospital, including long-term acute care hospitals and the home. A thorough understanding of the essentials of mechanical ventilation is requisite for respiratory therapists and critical care physicians. A general knowledge of the principles of mechanical ventilation is also required of critical care nurses and primary care physicians whose patients occasionally require ventilatory support.

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This book is intended to be a practical guide to adult mechanical ventilation. We have written this book from our perspective of over 75 years of experience as clinicians, educators, researchers, and authors. We have made every attempt to keep the topics current and with a distinctly clinical focus. As in the previous editions, we have kept the chapters short, focused, and practical.

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There have been many advances in the practice of mechanical ventilation over the past 10 years. Hence, much of the book is rewritten. Like previous editions, the book is divided into four parts. Part 1, Principles of Mechanical Ventilation, describes basic principles of mechanical ventilation and then continues with issues such as indications for mechanical ventilation, appropriate physiologic goals, and weaning from mechanical ventilation. Part 2, Ventilator Management, gives practical advice for ventilating patients with a variety of diseases. Part 3, Monitoring During Mechanical Ventilation, discusses blood gases, hemodynamics, mechanics, and waveforms. In the final part, Topics Related to Mechanical Ventilation, we discuss issues such as airway management, aerosol delivery, extracorporeal life support, and miscellaneous ventilatory techniques.

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This is a book about mechanical ventilation and not mechanical ventilators. We do not describe the operation of any specific ventilator (although we do discuss some modes specific to some ventilator types). We have tried to keep the material covered in this book generic and it is, by and large, applicable to any adult mechanical ventilator. We do not cover issues related to pediatric and neonatal mechanical ventilation. Because these topics are adequately covered in pediatric and neonatal respiratory care books, we decided to limit the focus of this book to adult mechanical ventilation. Although we provide a short bibliography at the end of each chapter, we have specifically tried to make this a practical book and not an extensive reference book.

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This book is written for all clinicians caring for mechanically ventilated patients. We believe that it is unique and hope you will enjoy reading it as much as we have enjoyed writing it.

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Dean R. Hess, PhD, RRT
Robert M. Kacmarek, PhD, RRT

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