Series Editor: Jean-Louis Vincent

Series Editor: Jean-Louis Vincent

3

Heidelberg Hong Kong London Milan Paris Tokyo

MECHANICAL VENTILATION

Volume Editors:

Arthur S. Slutsky, MD Laurent Brochard, MD

Professor of Medicine, Surgery Department of Intensive Care

and Biomedical Engineering Hospital Henri Mondor

University of Toronto University Paris XII

Vice-President, Research Créteil, France

St. Michael’s Hospital Toronto, Canada

Series Editor:

Jean-Louis Vincent, MD, PhD Head, Department of Intensive Care

Erasme University Hospital Brussels, Belgium

With 73 Figures and 34 Tables

3 1

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detailed bibliographic data is available in the Internet at http://dnb.ddb.de Printed on acid-free paper.

Hardcover edition © 2004 Springer-Verlag Berlin Heidelberg Softcover edition © 2005 Springer-Verlag Berlin Heidelberg

All rights are reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer-Verlag New York, Inc., 175 Fifth Avenue, New York, NY 10010, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden.

The use of general descriptive names, trade names, trademarks, etc., in this publication, even if the former are not specially identified, is not to be taken as a sign that such names, as understood by the Trade Marks and Merchandise Marks Act, may accordingly be used freely by anyone.

While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.

Production managed by A. Gösling, Heidelberg, Germany Typeset by Satz & Druckservice, Leimen, Germany Printed and bound by Mercedes-Druck, Berlin, Germany Printed in Germany

9 8 7 6 5 4 3 2 1 ISSN 1610-4056

ISBN 3-540-20267-6 SPIN 10965757

Springer-Verlag New York Berlin Heidelberg A member of Springer Science+Business Media

Prof. Arthur S. Slutsky, MD Prof. Laurent Brochard Professor of Medicine, Surgery and Department of Intensive Care

Biomedical Engineering Hospital Henri Mondor

Director, Interdepartmental Division University Paris XII

of Critical Care Medicine 94010 Créteil, France

University of Toronto Vice-President (Research) St. Michael’s Hospital

Queen Street Wing, Room 4-042

30 Bond Street, Toronto, ON M5B 1W8, Canada

Series Editor

Prof. Jean-Louis Vincent

Head, Department of Intensive Care Erasme University Hospital Route de Lennik 808 B-1070 Brussels Belgium

Epidemiology

The Importance of Acute Respiratory Failure in the ICU . . . . . 3 Y. Sakr and J.L. Vincent

The Epidemiology of Mechanical Ventilation . . . . . . . . 11 F. Frutos-Vivar, N.D. Ferguson, and A. Esteban

Long-term Outcomes of Mechanical Ventilation . . . . . . 29 L.D. Hudson, C.M. Lee, and J. R. Curtis

Understanding and Changing the Practice

of Mechanical Ventilation in the Community . . . . . . . . 47 G.D. Rubenfeld

Patient-ventilator Interactions, Weaning, and Monitoring

Control of Breathing During Mechanical Ventilation . . . . . . . 63 M. Younes

Patient-ventilator Interactions . . . . . . . . . . . . 83 S. Parthasarathy and M.J. Tobin

Physiological Rationale for Ventilation of Patients

with Obstructive Diseases . . . . . . . . . . . . . . 97 J. Mancebo

Role of the Clinician in Adjusting Ventilator Parameters

During Assisted Ventilation . . . . . . . . . . . . . 113 L. Brochard

Neurally-adjusted Ventilatory Assist . . . . . . . . . . . 125 C. Sinderby, J. Spahija, and J. Beck

Contents

Liberating Patients from Mechanical Ventilation:

What Have we Learned About Protocolizing Care? . . . . . 135 J.W.W. Thomason and E.W. Ely

Novel Approaches

to Monitoring Mechanical Ventilatory Support . . . . . . . 153 N. MacIntyre

Non-invasive Ventilation

Indications for Non-invasive Ventilation . . . . . . . . 171 N.S. Hill, T. Liesching, and H. Kwok

Non-invasive Ventilation: Causes of Success or Failure . . . . . . 189 S. Nava and P. Ceriana

Non-invasive Ventilation in Immunocompromised Patients . . . 201 M. Antonelli, M.A. Pennisi, and G. Conti

ARDS/VILI: Mechanisms

Biophysical Factors Leading to VILI . . . . . . . . . . . 213 N. Vlahakis, J.C. Berrios, and R.D. Hubmayr

Vascular Contribution to VILI . . . . . . . . . . . 227 J.J. Marini, J.R. Hotchkiss, and A.F. Broccard

VILI: Physiological Evidence . . . . . . . . . . . . 243 J.D. Ricard, D. Dreyfuss, and G. Saumon

Systemic Effects of Mechanical Ventilation . . . . . . . . 259 Y. Imai and A.S. Slutsky

ARDS/VILI: Assessment

Chest Wall Mechanics in ARDS . . . . . . . . . . . 275 L. Gattinoni, D. Chiumello, and P. Pelosi

Targets in Mechanical Ventilation for ARDS . . . . . . . . . 287 B.P. Kavanagh

How to Detect VILI at the Bedside? . . . . . . . . . . . . 301 P.P. Terragni, B. Chiaia, and V.M. Ranieri

Lung Morphology in ARDS: How it Impacts Therapy . . . . . 319 J.J. Rouby and C.R. de A Girardi

VI Contents

ARDS/VILI: Therapy

Recruitment Maneuvers in ARDS . . . . . . . . . . . . 335 V.N. Okamoto, J.B. Borges, and M.B.P. Amato

Spontaneous Breathing During Ventilatory Support

in Patients with ARDS . . . . . . . . . . . . . . . . 353 C. Putensen, R. Hering, and H. Wrigge

Pressure-support Ventilation in Patients with ALI/ARDS . . . . 367 N. Patroniti, B. Cortinovis, and A. Pesenti

Prone Ventilation . . . . . . . . . . . . . . . . 381 R.K. Albert

Adjuncts to Mechanical Ventilation

for ARDS including Biological Variability . . . . . . . . . 389 R.M. Kacmarek

Summary of Clinical Trials of Mechanical Ventilation in ARDS . 405 R.G. Brower and G.D. Rubenfeld

Subject Index . . . . . . . . . . . . . . . . . . 415 Contents VII

Albert R.K.

Dept of Medicine

Denver Health Medical Center 777 Bannock, MC 4000 Denver, CO 80206-4507 USA

Amato M.

Respiratory Intensive Care Unit Hospital das Clinicas

Av Dr Eneas Carvalho de Aguiar 255 Sao Paulo

Brazil

Antonelli M.

Dept of Anesthesiology and Intensive Care Policlinico A. Gemelli Largo A Gemelli 8 00168 Rome Italy

Beck J.

Dept of Critical Care Medicine St-Michaels Hospital 30 Bond Street

Toronto, Ontario M5B1W8 Canada

Berrios J.C.

Thoracic Diseases Research Unit Division of Pulmonary

and Critical Care Medicine Dept of Medicine Mayo Clinic 200 First Street SW Rochester, MN 55905 USA

Borges J.B.

Respiratory Intensive Care Unit Hospital das Clinicas

Av Dr Eneas Carvalho de Aguiar 255 Sao Paulo

Brazil

Broccard A.F.

Dept of Pulmonary and Critical Care Medicine Regions Hospital 640 Jackson Street St. Paul, MN 55101 USA

Brochard L.

Dept of Medical Intensive Care Hôpital Henri Mondor

51 Avenue du Maréchal de Lattre de Tassigny

94010 Créteil France

Brower R.G.

Dept of Pulmonary & Critical Care Medicine

Johns Hopkins Hospital Baltimore, MD 21287 USA

Ceriana P.

Respiratory Intensive Care Unit Fondazione S. Maugeri Via Ferrata 8

27100 Pavia Italy

Contributors

Chiaia B.

Polytechnic of Turin

Department of Structural Engineering Turin

Italy

Chiumello D.

Dept of Anesthesiology and Intensive Care

Ospedale Maggiore Policlinico-IRCCS Via Francesco Sforza 35

20122 Milan Italy

Conti G.

Dept of Anesthesiology and Intensive Care Policlinico A. Gemelli Largo A Gemelli 8 00168 Rome Italy

Cortinovis B.

Institute of Anesthesia and Intensive Care Dept of Surgical Science and Intensive Care San Gerardo Hospital Via Donizetti 106 20052 Milan Italy

Curtis J.R.

Division of Pulmonary and Critical Care Medicine Harborview Medical Center Box 359762

325 Ninth Avenue Seattle, WA 98104 USA

de A Girardi C. R.

Dept of Surgical Intensive Care Pierre Viars

Hôpital Pitié-Salpétrière 83 Boulevard de l’Hôpital 75013 Paris

France

Ely E.W.

Center for Health Services Research 6^thFloor Medical Center East, #6109 Vanderbilt University Medical Center Nasville, TH 37232-8300

USA

Esteban A.

Dept of Intensive Care University Hospital

Carretera de Toledo Km 12,500 Getafe, Madrid 28905

Spain

Dreyfuss D.

Dept of Intensive Care Hôpital Louis Mourier 92700 Colombes France

Ferguson N.D.

Dept of Medicine Division of Respirology and Interdepartmental Division of Critical Care

University of Toronto Toronto

Canada

Frutos-Vivar F.

Dept of Intensive Care University Hospital

Carretera de Toledo Km 12,500 Getafe, Madrid 28905

Spain

Gattinoni L.

Dept of Anesthesiology & ICU Ospedale Maggiore Policlinico-IRCCS Via Francesco Sforza 35

20122 Milan Italy

Hering R.

Dept of Anesthesiology & ICU University Hospital

Siegmund-Freud-Str. 35 53105 Bonn

Germany

X List of Contributors

Hill N.S.

Pulmonary, Critical Care and Sleep Division

Tufts-New England Medical Center 750 Wahington St #257

Boston, MA 02111 USA

Hotchkiss J.R.

Dept of Pulmonary and Critical Care Medicine Regions Hospital 640 Jackson Street St. Paul, MN 55101 USA

Hubmayr R.D.

Dept of Physiology & Biophysics Stabile 8-18

Mayo Clinic 200 First Street SW Rochester, MN 55905 USA

Hudson L.D.

Division of Pulmonary and Critical Care Medicine

Harborview Medical Center Box 359762

325 Ninth Avenue Seattle, WA 98104 USA

Imai Y.

Interdepartmental Division

of Critical Care Medicine and Division of Respirology

Dept of Medicine St Michael’s Hospital 30 Bond Street

Toronto, Ontario M5B1W8 Canada

Kacmarek R.M.

Respiratory Care Ellison 401

Massachusetts General Hospital 55 Fruit Street

Boston, MA 02114 USA

Kavanagh B.P.

Dept of Anesthesia and Medicine Hospital for Sick Children 555 University Avenue Toronto, Ontario M5G 1X8 Canada

Kwok H.

Pulmonary, Critical Care and Sleep Division

Tufts-New England Medical Center 750 Wahington St #257

Boston, MA 02111 USA

Lee C.M.

Division of Pulmonary and Critical Care Medicine

Harborview Medical Center Box 359762

325 Ninth Avenue Seattle, WA 98104 USA

Liesching T.

Pulmonary, Critical Care and Sleep Division

Tufts-New England Medical Center 750 Wahington St #257

Boston, MA 02111 USA

MacIntyre N.

Respiratory Care Room 7451, Duke North Duke University Medical Center Box 3911

Durham, NC 27710 USA

Mancebo J.

Dept of Intensive Care Hopsital de Sant Pau Av. S.A.M. Claret 167 08025 Barcelona Spain

List of Contributors XI

Marini J.J.

Dept of Pulmonary and Critical Care Medicine Regions Hospital 640 Jackson Street St. Paul, MN 55101 USA

Nava S.

Respiratory Intensive Care Unit Fondazione S. Maugeri Via Ferrata 8

27100 Pavia Italy

Okamoto V.N.

Respiratory Intensive Care Unit Hospital das Clinicas

Av Dr Eneas Carvalho de Aguiar 255 Sao Paulo

Brazil

Parthasarathy S.

Division of Pulmonary and Critical Care Medicine Edwards Hines Jr., Veterans Administrative Hospital Route 111N

Hines, IL 60141 USA

Patroniti N.

Institute of Anesthesia and Intensive Care Unit Dept of Surgical Science and Intensive Care San Gerardo Hospital Via Donizetti 106 20052 Milan Italy

Pelosi P.

Dept of Clinical and Biological Sciences

Universita degli Studi dellInsubria Varese

Italy

Pennisi M.A.

Dept of Anesthesiology and Intensive Care Policlinico A. Gemelli Largo A Gemelli 8 00168 Rome Italy

Pesenti A.

Institute of Anesthesia and Intensive Care Unit Dept of Surgical Science and Intensive Care San Gerardo Hospital Via Donizetti 106 20052 Milan Italy

Putensen C.

Dept of Anesthesiology and Intensive Care University Hospital Siegmund-Freud-Str. 35 53105 Bonn

Germany

Ranieri V.M.

Dept of Anesthesiology and Intensive Care

Ospedale S. Giovanni Battista Corso Dogliotti 14

10126 Torino Italy

Ricard J.D.

Dept of Intensive Care Hôpital Louis Mourier 92700 Colombes France

Rouby J.J.

Dept of Surgical Intensive Care Pierre Viars

Hôpital Pitié-Salpétrière 83 Boulevard de lHôpital 75013 Paris

France

XII List of Contributors

Rubenfeld G.D.

Division of Pulmonary and Critical Care Medicine Harborview Medical Center University of Washington Box 359762

325 9^thAvenue Seattle, WA 98104-2499 USA

Sakr Y.

Dept of Intensive Care Erasme Hospital

Free University of Brussels Route de Lennik 808 1170 Brussels Belgium

Saumon G.

Xavier Bichat Faculty of Medicine 16 rue Henri Huchard

75018 Paris France

Sinderby C.

Dept of Critical Care Medicine St-Michaels Hospital 30 Bond Street

Toronto, Ontario M5B1W8 Canada

Slutsky A.S.

Interdepartmental Division of Critical Care Medicine and Division of Respirology Dept of Critical Care Medicine St Michaels Hospital

30 Bond Street

Queen Wing, Room 4-042 Toronto, Ontario M5B1W8 Canada

Spahija J.

Dept of Critical Care Medicine St-Michaels Hospital 30 Bond Street

Toronto, Ontario M5B1W8 Canada

Terragni P.P.

Dept of Anesthesiology and Intensive Care

Ospedale S. Giovanni Battista Corso Dogliotti 14

10126 Torino Italy

Thomason J.W.W.

Center for Health Services Research 6^thFloor Medical Center East, #6109 Vanderbilt University Medical Center Nasville, TH 37232-8300

USA

Tobin M.J.

Division of Pulmonary and Critical Care Medicine Edwards Hines Jr., Veterans Administrative Hospital Route 111N

Hines, IL 60141 USA

Vincent J.L.

Dept of Intensive Care Erasme Hospital

Free University of Brussels Route de Lennik 808 1170 Brussels Belgium

Vlahakis N.

Thoracic Diseases Research Unit Division of Pulmonary

and Critical Care Medicine Dept of Medicine Mayo Clinic 200 First Street SW Rochester, MN 55905 USA

Wrigge H.

Dept of Anesthesiology and Intensive Care University Hospital Siegmund-Freud-Str. 35 53105 Bonn

Germany

List of Contributors XIII

Younes M.

Dept of Medicine St Michael’s Hospital 30 Bond Steeet

Toronto, Ontario M5B 1W8 Canada

XIV List of Contributors

ALI Acute lung injury

APACHE Acute physiology and chronic health evaluation ARDS Acute respiratory distress syndrome

COPD Chronic ostructive pulmonary disease CPAP Continuous positive airways pressure FRC Functional residual capacity

HFOV High frequency oscillatory ventilation ICU Intensive care unit

IMV Intermittent mandatory ventilation LIP Lower inflection point

NAVA Neurally adjusted ventilatory assist NIV Non-invasive ventilation

PEEP Positive end-expiratory pressure PSV Pressure support ventilation SBT Spontaneous breathing trial UIP Upper inflection point

VILI Ventilator-induced lung injury

VT Tidal volume

Common Abbreviations

Epidemiology