Manual of Neonatal Respiratory Care, Fifth Edition

Respiratory care is the largest overall component of neonatal intensive care, and the fifth edition of the Manual of Neonatal Respiratory Care is the leading bedside guide for all aspects of respiratory care in the neonatal intensive care unit. Its easy-to-read outline format is simple yet comprehensive and covers all aspects of lung disease in the newborn infant, including embryology, principles of mechanical ventilation, procedures and techniques, monitoring, devices, adjunctive therapies, management of respiratory illness, complications, outcomes, and related issues.  The latest edition includes fully revised and updated information, coverage on new equipment and devices, and an expanded authorship to enhance its international appeal. The new edition also features two new co-editors, Dr. Mark Mammel and Dr. Anton Van Kaam, internationally recognized experts in the field who bring a fresh perspective to the manual.  Divided into sixteen sections, the book begins with a section on lung development and maldevelopment, specifically covering the development of the respiratory system, malformations, deformations, disorders of the neonatal airway, and developmental lung anomalies. The second section reviews the principles of mechanical ventilation, with coverage on such topics as spontaneous breathing, oxygen therapy, oxygen toxicity, pulmonary mechanics, and ventilator parameters. The third section of the manual outlines procedures and techniques, including neonatal resuscitation, laryngoscopy and endotracheal intubation, and tracheostomy. The following section dives into the monitoring of the ventilated patient, specifically focusing on continuous monitoring techniques, clinical controversies in pulse oximetry, and echocardiography. The next section spotlights noninvasive ventilatory techniques, such as nasal interfaces, humidified high-flow nasal cannula therapy, and sustained inflation. The sixth section of the manual focuses on ventilatory modes and modalities, with coverage on intermittent mandatory ventilation, pressure support ventilation, and pressure control ventilation. The following section segues into high-frequency ventilation, reviewing general concepts, high-frequency jet ventilation, and high-frequency oscillatory ventilation. The eighth section centers around commonly used neonatal ventilators, such as the DRAEGER VN500 ventilator, the AVEA ventilator, and the Twinstream ventilator. The ninth section reviews adjunctive therapies, including hemodynamic support, nutritional support, the use of sedation and analgesia, inhaled nitric oxide therapy, and ECMO. The tenth section shifts gears to spotlight the management of common neonatal respiratory diseases, with chapters on mechanisms of respiratory failure, tissue hypoxia, respiratory distress syndrome, persistent pulmonary hypertension, and pulmonary hypoplasia/agensis among others. Section eleven reviews the etiology, pathogenesis, and management of bronchopulmonary dysplasia, as well as the long-term outcome of newborns with this chronic lung disease. The next section presents complications associated with mechanical ventilation, such as thoracic air leaks, neonatal pulmonary hemorrhage, and neurologic complications. The following two sections spotlights ethical, legal and other considerations, among them nursing care of the ventilated infant, long-term ventilator dependency, home ventilation, withdrawal of ventilatory support, and medical liability and risk management. The fifteenth section focuses on research and literature, with coverage on interpreting medical literature, data collection and assessment of respiratory outcomes, and contemporary classics in neonatal respiratory care. The final section presents ventilatory case studies.  The text also features over 300 high-yield radiographic images, figures, tables, and algorithms.

Table of Contents:

Part I. Lung Development and Maldevelopment

1. Development of the Respiratory System

2. Malformations, Deformations, and Disorders of the Neonatal Airway

3. Developmental Lung Anomalies

Part II. Principles of Mechanical Ventilation

4. Spontaneous Breathing

5. Pulmonary Gas Exchange

6. Oxygen Therapy

7. Oxygen Toxicity

8. Pulmonary Mechanics and Energetics

9. Basic Principles of Mechanical Ventilation

10. Classification of Mechanical Ventilation Devices

11. Ventilator Parameters

12. Respiratory Gas Conditioning and Humidification

Part III. Procedures and Techniques

13. Cardiorespiratory Examination

14. Neonatal Resuscitation

15. Laryngoscopy, Tracheal Intubation, and Laryngeal Mask Airway

16. Vascular Access

17. Tracheostomy

Part IV. Monitoring the Ventilated Patient

18. Continuous Monitoring Techniques

19. Clinical Controversies in Pulse Oximetry

20. Interpretation of Blood Gases

21. Volumetric Capnography in Critically Ill Neonates and Children

22. Neonatal Pulmonary Graphics

23. Diagnostic Imaging

24. Transillumination

25. Echocardiography

26. Bronchoscopy

Part V. Noninvasive Ventilatory Techniques

27. Nasal Interfaces for Noninvasive Ventilation

28. Humidified High-Flow Nasal Cannula Therapy

29. Continuous Distending Pressure

30. Sustained Inflations

31. Noninvasive Ventilation: An Overview

32. Nasal Intermittent Positive Pressure Ventilation (NIPPV)

33. Practical Applications of Nasal High-Flow Therapy

Part VI. Ventilatory Modes and Modalities

34. Intermittent Mandatory Ventilation

35. Synchronized Intermittent Mandatory Ventilation

36. Assist/Control Ventilation

37. Pressure Support Ventilation

38. Volume-Targeted Ventilation

39. Pressure Control Ventilation

Part VII. High-Frequency Ventilation

40. High-Frequency Ventilation: General Concepts

41. High-Frequency Jet Ventilation

42. High-Frequency Oscillatory Ventilation

Part VIII. Commonly Used Neonatal Ventilators

43. Ventilator Mode Classification

44. AVEA Ventilator

45. Twinstream Ventilator

46. Puritan Bennett 840 and Puritan Bennett 980 Ventilators

47. Draeger VN 800/600/500

48. Neurally Adjusted Ventilatory Assist (NAVA) Ventilation

49. Servo Ventilator Systems

50. SLE6000/5000/4000 Infant Ventilators

51. Stephanie and Sophie Ventilators

52. Leoni Plus Ventilator

53. Fabian HFO Ventilator (Acutronic)

54. Bunnell LifePulse High-Frequency Jet Ventilator

55. High-Frequency Oscillatory Ventilators

Part IX. Adjunctive Therapies

56. Hemodynamic Support of the Newborn

57. Nutritional Support in Respiratory Failure

58. Surfactant Replacement Therapy

59. Pharmacologic Agents

60. Automatic Control of Inspired Oxygen Concentration

61. Aerosolization and Nebulization

62. Sedation and Analgesia

63. Inhaled Nitric Oxide Therapy

64. Extracorporeal Membrane Oxygenation

Part X. Management of Common Neonatal Respiratory Diseases

65. Mechanisms of Respiratory Failure

66. Tissue Hypoxia

67. Indications for Mechanical Ventilation

68. Respiratory Distress Syndrome

69. Pneumonia in the Newborn Infant

70. Meconium Aspiration Syndrome

71. Persistent Pulmonary Hypertension of the Newborn

72. Congenital Diaphragmatic Hernia

73. Pulmonary Hypoplasia

74. Chylothorax

75. Apnea, Bradycardia, and Desaturation

76. Optimizing Lung Volume

77. Weaning and Extubation

Part XI. Bronchopulmonary Dysplasia

78. Etiology and Pathogenesis

79. Bronchopulmonary Dysplasia: Clinical Management

80. Long-Term Outcomes of Newborns with Bronchopulmonary Dysplasia

Part XII. Complications Associated With Mechanical Ventilation

81. Thoracic Air Leaks

82. Patent Ductus Arteriosus

83. Neonatal Pulmonary Hemorrhage

84. Retinopathy of Prematurity

85. Neurologic Complications of Mechanical Ventilation

Part XIII. Other Considerations

86. Respiratory Focused Nursing Care of the Neonate

87. Transport of Ventilated Babies

88. Role of the Respiratory Therapist in the NICU

89. Long-Term Ventilator Dependency in Infants Without Lung Disease

90. Chronic Home Mechanical Ventilation

91. Discharge Planning and Follow-Up of the NICU Graduate

Part XIV. Ethical and Legal Considerations

92. Initiation of Life Support at the Border of Viability

93. Withdrawal of Ventilatory Support: Ethical and Practical Considerations

94. Medical Liability, Documentation, and Risk Management

Part XV. Research, Quality, and the Literature

95. Interpreting Clinical Research

96. Quality Improvement in Neonatal Respiratory Care

97. Data Collection and Assessment of Respiratory Outcomes

98. Contemporary Classics in Neonatal Respiratory Care

Part XVI. Ventilatory Case Studies

99. Ventilatory Cases

Back Matter