Index. D Dry powder inhalers (DPIs), 293, 294

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1 Index A Acute hypoxemic respiratory failure (AHRF) community-acquired pneumonia, 52 continuous positive airway pressure, 80 endotracheal intubation, 78 immunocompetent and immunosuppressed patients, 78 nonrandomized studies, 77 oxygenation, 78 randomized clinical trials, 79 immunosuppression, influenza A (H1N1), mortality rate, 52 NIV failure rate, 53 tuberculosis, 55 Acute Physiology and Chronic Health Evaluation (APACHE), 131 Acute respiratory distress syndrome (ARDS), 330 AECC diagnostic criteria, 111 APRV, 150 Berlin definition, 111 heated humidifiers, malarial patients, pathogenesis, 112 prevalence rate, acute-care settings, advantages, 117 applications, PA-H1N1 infection, NIMV, 154, 155 SARS, 130 Acute respiratory failure (ARF), anthrax (see Anthrax) controlled studies and meta-analyses, 256 failure prediction, 94 first-line treatment, 262 HIV/AIDS patients bacterial pneumonia, diagnosis, 88 lung infection, 87 mechanical ventilation, 86 physiopathology, P. jirovecii pneumonia, 86, 88 prospective assessment, 88 retrospective analysis, 87 ICU, 281 influenza A (H1N1) APRV, 150 ARDS, history of, 145 invasive mechanical ventilation, 139 NIMV, NIV treatment, pulmonary infiltrate, 258 S/T-BIPAP+ AVAPS ventilation strategy, ventilation systems and mortality rates, ventilator support, 257 MV indication, 94 PA-H1N1 ICU mortality rate, 154 noninvasive mechanical ventilation, pandemics, 256 patient selection, physiological effects, pneumonia, 259 SARS, 256 type and severity, 262 ventilation, 93 ventilator support mechanism, 263 A.M. Esquinas (ed.), Noninvasive Ventilation in High-Risk Infections and Mass Casualty Events, DOI / , Springer-Verlag Wien

2 364 Aerodynamic diameter (AED), 316 Aerosol definition, 291 dispersion circuit modifications, 318 control measures, 319 experimental studies, 317, 318 human study, 318 IPAP pressures, 317 NIV mask and exhalation devices, Wells evaporation-falling curve droplets, nebulizer systems, 293 patient characteristics, 295 physical characteristics, 295 transmission aerosol-generating procedures, definitions, 270 infectious agents, 271, 274 infectious dose, mechanism, transmission mechanisms, 316 Aerosol-generating procedures (AGPs), Airborne disease transmission chest physiotherapy, 308 continuous positive airway pressure, 309 endotracheal intubation, 309 health care environment, 310 health care workers mechanical ventilation, 309 SARS transmission, 308 tuberculosis, 309 vaccination, 306 infection-control strategy, 310 influenza A and B, 306, 309 respiratory droplets, standard personal protective equipment, 310 swine-origin influenza virus, 311 tracheal intubation, 308 unidirectional/displacement ventilation system, 310 American-European Consensus Conference (AECC), 111 Anthrax as biological warfare agent, 176 cutaneous anthrax, 175 gastrointestinal anthrax, 175 inhalational anthrax antibiotic therapy, 178 clinical presentation of, hemorrhagic pneumonitis, 177 mediastinal adenopathy, 177 NPPV, role of, weapons-grade anthrax, mortality rate, 176 Apnea, 253 ARDS. See Acute respiratory distress syndrome (ARDS) ARF. See Acute respiratory failure (ARF) Aspergillus spores, 286 Aspiration pneumonia, 5 Aspiration reflex (AspR), 4 5 Atelectasis, 65 Average volume-assured pressure support (AVAPS), B Bacillus anthracis, 175 Bacterial filters, Bilevel positive airway pressure (BIPAP), Bioterrorism, 176 Bronchoscopy, 204, Bubble continuous positive airway pressure eligibility and weaning criteria, 222 equipment and design, facility considerations, 225 nursing care, younger age range, 222 Bubble-through humidifier, 37, 38 Bucconasal masks, 244 Burn injuries atelectasis and hypostatic pneumonia, 212 in children and adults, 211 intubation and mechanical ventilation, 213 benefit of, helmets, patient intolerance, 216 ventilator-associated pneumonia incidence of, 213 in pediatric ICUs, 212 preventive strategies, 213 wound infections, 212 C Cascade humidifiers, 37, 38 Chemical agent cyanides, definition of, 163 nerve agents, NPPV role, 172 pulmonary agents, riot-control agents, Index

3 Index 1994 sarin nerve agent attack, 163 vesicants, Chest physiotherapy, 308 Chest trauma, Children acute respiratory failure ( see Acute respiratory failure (ARF)) air leaks and straps, 252 anxiety, 252 apnea and pneumonia, 253 burn injuries, 211 complications, 253 helmets, 252 influenza (H1N1), 252 midazolam/ketamine, 252 oronasal mask, 252 radiologic assessment, 253 severe bronchiolitis bucconasal masks, 244 clinical presentations, 233 clinical studies, 237, 238 CPAP (see Continuous positive airway pressure (CPAP)) facial masks, 244 helmets, 244 high-flow cannulas, , 243 invasive procedures, 237 nasal prongs, small nasal masks, 244 ventilator assistance, 239 ventilator settings, ventilator support, criteria of, ventilatory mechanics, Chlamydophila pneumoniae, 88 Chronic obstructive pulmonary disease (COPD) arterial blood gases values, 326 intensive care unit, 280 Clostridium diffi cile, 286 Cochrane Neonatal Review Group, 228 ComfortFull 2 mask, Community-acquired pneumonia (CAP), 52 acute hypoxemic respiratory failure continuous positive airway pressure, 80 endotracheal intubation, 78 immunocompetent and immunosuppressed patients, 78 nonrandomized studies, 77 oxygenation, 78 randomized clinical trials, 79 epidemiology and etiology, expiratory and inspiratory sensitivity, 76 flow-triggered inspiration, H1N1 infection, 81 humidification system, 77 inspiratory effort and flow administration, 76 inspiratory ramp/flow rate, 76 leak compensation system, 77 Legionella, 81 L. pneumophilia pneumonia ALI/ARDS, NIV failure rates, 102 ARF patients, NIV failure, mortality rates, 101 pathophysiology, patient selection, PEEP valves, 77 prognosis, Streptococcus pneumoniae, 100, 101 Continuous positive airway pressure (CPAP), 53, 62, 227 airborne disease transmission, 309 hematological patients, hypoxemic ARF, 185 pneumonia, 80 Conventional mechanical ventilation (CMV), 203, 205, 206 Coughing airborne infections, dissemination of, 3 aspiration and expiration reflexes, 4 5 breathing maneuvers, 4 5 pandemic virus A (H1N1), 3 Cyanide, D Dry powder inhalers (DPIs), 293, 294 E Endotracheal intubation (ETI), 330, 357 European Society of Intensive Medicine and the European Respiratory Society, 352 Expiration reflex (ExpR), 4 5 Expiratory positive airway pressure (EPAP), 317 External high-frequency oscillation (EHFO), 166 F Facial masks, 244 Falciparum malaria, ARDS, pathogenesis of, 112 prevalence of,

4 366 Fiberoptic bronchoalveolar lavage (FBAL), 185 Fiberoptic bronchoscopy (FB) in airway management, 204 pulmonary infections, NIV, G Grading of Recommendations Assessment, Development and Evaluation (GRADE), 275 H Haemophilus influenza, 87 Health care-associated infections (HCAIs), 287 Health care workers (HCWs) aerosol transmission, contagious disease transmission via NIV droplet/aerosol dispersion, 30 full-face mask, 31, 32 helmet, 31, 32 H1N1 influenza patients, 30 mycobacterial tuberculosis, 158 nasal mask, 30, 32 precautionary steps, SARS patients, 29 30, total-face mask, 31, 32 vented masks, 31 infection transmission, 315 mechanical ventilation, 309 safety measures, 327 SARS transmission, 308 tuberculosis, 309 vaccination, 306 Heat and moisture exchangers (HMEs), 36 in ARDS patients, 40 artificial noses, 36 during NIV, 41 spontaneous-breathing trials, 41 very-low-birth-weight infants, 41 Heated humidifiers (HHs), 36 active HMEs, 42 in adult intensive care unit, 39, 40 in ARDS patients, cascade humidifiers, 37, 38 complications of, contraindications, 42 faulty operation, 39 hypothermia, 41 during, 41 operating range, passover humidifier, 37, 38 Index permanent default temperature setting, 39 precautions and warnings, 42, 43 safety features, 39 spontaneous-breathing trials, 41 very-low-birth-weight infants, 41 weaning, 41 Helmets, 244 Hering Breuer expiration facilitating reflex (HBEFR), 4, 5 High-efficiency particulate air (HEPA) filter, 286 High-flow nasal cannulas (HFNC), 229 High-frequency jet ventilation by mask (HFJV-M) advantages, 46 aerosol infection, prevention, 47 bioterrorist attack, 46 continuous positive airway pressure, 46 pressure generator, 45 Human patient simulator (HPS) model. See Noninvasive ventilation (NIV) Hypothermia, 41, 42 I Immunosuppression, Infectious lung disease posttransplant pneumonia, posttransplant surgical procedures, 199 posttransplant infectious disease, Influenza A (H1N1), 326. See also Pandemic influenza acute hypoxemic respiratory failure, APRV, 150 children and ARF ARDS, pulmonary infiltrate, 258 ventilator support, 257 history of, 145 invasive mechanical ventilation, 139 NIMV, NIV treatment, S/T-BIPAP+ AVAPS ventilation strategy, ventilation systems and mortality rates, Inhalational anthrax antibiotic therapy, 178 clinical presentation of, hemorrhagic pneumonitis, 177 mediastinal adenopathy, 177 NPPV role,

5 Index Inhalation profile recorder (IPRs), 293 Inhalation therapy Aeroliser and HandiHaler, 293 aerosol characteristics, 295 controlling bronchial obstruction, 290 definition, 291 drug delivery, 296 dry powder inhalers, 293, 294 health professionals, 297 heliox uses, 296 inhalation profile recorder, 293 metered dose inhalers advantages, 292 advantages and disadvantages, 294 hand-lung coordination, 293 spacer accessory, 292 methodology, 291 nebulizer systems, 293, 294 NIV-Droplet dispersion, nursing care, pressurized metered dose inhalers, 292, 294 Turbuhaler and Diskus, 293 Inspiratory positive airway pressure (IPAP), 9, 12, 317 Institutional Influenza Committee (IIC), Intensive care unit (ICU) COPD, 280 equipment, European recommendations, 351 hypercapnic COPD patients, 330 NIMV, pandemic influenza, 338 ventilator-associated pneumonia, 279, 280 Interface devices advantages and disadvantages full-face mask, 18, 21, 22 nasal masks, nasal pillows, 19, 23, 24 oronasal mask, 20, 25, 26 complications of, 23, 26 for, 18 patients, monitoring of, requisites of, 18 unintentional air leak, Invasive mechanical ventilation (IMV) cancer patients, 189 respiratory failure, 131 Isothermic saturation boundary (ISB), 35 K Ketamine, 252 L Laryngeal mask (LM) airway, 230 Legionella pneumonia CAP, ICU admission ALI/ARDS, NIV failure rates, 102 ARF patients, NIV failure, mortality rates, 101 clinical manifestations, 100 laboratory findings, 100 mortality, 99 multilobar pneumonia, symptoms, 100 Legionnaires disease. See Legionella pneumonia Low-flow nasal cannulas, M Malaria ARDS patients, pathogenesis of, 112 prevalence of, Plasmodium infection, Membrane-type heated humidifier, 37, 38 Metered dose inhalers (MDIs) advantages, 292 advantages and disadvantages, 294 hand-lung coordination, 293 spacer accessory, 292 Methicillin-resistant Staphylococcus aureus (MRSA), 286 Midazolam, 252 Mixed-type ventilation, 286 Multilobar pneumonia, Mycobacterial tuberculosis aerosol-producing procedures, 158, 159 air infection isolation room, 159 disinfectants, 159, 160 HCWs, 158 infection and transmission course of, pulmonary tuberculosis, acute exacerbations of, surgical face masks, 158 Mycoplasma pneumoniae, 88 N Nasal prongs, Nebulizer systems, 293, 294 Negative-pressure rooms,

6 368 Neonatal transport continuous positive airway pressure, 227, high-flow nasal cannulas, 229 laryngeal mask airway, 230 low-flow nasal cannulas, oropharyngeal airways, 227 Nerve agents, Noninvasive mechanical ventilation (NIMV) chemical agent exposure, hematological patients, hypoxemic ARF CPAP ventilation/oxygen alone, 182, 183 FBAL, 185 IMV, 182, 184 mortality rates, ventilation modality and interface, mycobacterial tuberculosis (see Mycobacterial tuberculosis) novel H1N1 influenza infection, ARF, PA-H1N1-associated respiratory failure, Noninvasive positive-pressure ventilation (NIPPV), 62 in burn patients, 214, 215 chemical agent exposure, 172 exhaled air dispersion ComfortFull 2 mask, Image 3 mask, whisper swivel, ResMed Mirage mask, 11 inhalational anthrax, Noninvasive ventilation (NIV) AHRF (see Acute hypoxemic respiratory failure (AHRF)) ARDS patients in acute-care settings, advantages, 117 application, burn patients (see Burn injuries) children (see Acute respiratory failure (ARF)) vs. CMV, definition, 291 endotracheal intubation, 280 exhaled air dispersion, HPS model airflow visualization, 9 10 ComfortFull 2 mask, image analysis, 10 image capture and frame extraction, 10 Image 3 mask, whisper swivel, intensity averaging and concentration normalization, Index lung model, 8 9 nosocomial SARS outbreaks, 7, 14 pneumonia, pulmonary TB, 8 ResMed Mirage mask, 11 smoke particles, limitations, HCWs, contagious disease transmission (see Health care workers (HCWs)) heated humidifiers, 41 HFJV-M (see High-frequency jet ventilation by mask (HFJV-M)) high-risk infections, guidelines and protocol clinical course and failure rate, indications and contraindication, interface, practical approach, 347 recommendations, 349 ventilation mode, 348 immunocompromised patient administrative participation, categoroies, 334 hospital resources, 334 NIV contraindications, 334 patient monitoring, 335 personnel responsible, 335 immunodeficient patient, 326 infectious lung disease posttransplant pneumonia, posttransplant surgical procedures, 199 interfaces (see Interface devices) malarial ARDS patients, modalities, 110 mycobacterial tuberculosis aerosol-producing procedures, 158, 159 air infection isolation room, 159 disinfectants, 159, 160 droplet nuclei, HCWs, 158 pulmonary tuberculosis, acute exacerbations of, surgical face masks, 158 newborn (see neonatal transport) nosocomial infection, 280 PA-H1N1 (see Pandemic influenza) pediatrics (see Children) pulmonary infections in critically ill patients, fiberoptic bronchoscopy, SARS patients (see Severe acute respiratory syndrome (SARS))

7 Index solid cancer patients acute respiratory failure, 191 after thoracic surgery, 190 do-not-intubate/palliative-care patients, 192, 193 studies of, 190 weaning patient, 281 O Oronasal mask, 252 Oropharyngeal airways, 227 P Pandemic flu pneumonia European recommendations equipment and material, 353 ICU admission, 351 infection-control procedures, 352 invasive ventilation, 352 oxygen therapy, 352 Scottish Government and Health Protection Scotland, 353 World Health Organization, 354 Pandemic influenza hospital organization, 339 Institutional Influenza Committee, intensive care units, 338 medical care, 337 pandemic influenza A (PA-H1N1) history of, 145 ICU mortality rate, 154 NIV, noninvasive mechanical ventilation, patient discharge, 340 personnel management, protocols, 340 Passover humidifiers, 37, 38 Phosgene, 169 Pneumocystis jirovecii pneumonia, 54, 86 Pneumonia, 253 CAP (see Community-acquired pneumonia (CAP)) Legionella pneumophila ( see Legionella pneumonia) pandemic flu pneumonia ( see Pandemic flu pneumonia) posttransplant pneumonia, NIV treatment in, Polytrauma patients atelectasis, 65 clinical approach, 65 computed tomography, 64 CPAP, 62 invasive mechanical ventilation, 62, 63 NIPPV, 62 oxygenation, PC/FC injury, 63 prevention trial, 63 respiratory support, spontaneous breathing, 66 ventilatory management, 63 Positive end-expiratory pressure (PEEP), 54 Pressurized metered dose inhalers (pmdis), 292, 294 Pseudomonas aeruginosa, 88 Pulmonary agents, R Radiologic assessment, 253 Release airway pressure ventilation (APRV), 150 ResMed Mirage face mask, 8 9, 11 Riot control agents, S Sepsis-Related Organ Failure Assessment (SOFA), 103, 142 Severe acute respiratory syndrome (SARS), 256, 257, ARDS, 130 clinical course of, 129 coronavirus, 129 droplet-respiratory transmission, 307 endotracheal intubation, 259 infection control implications, 260 intubation/suctioning, 309 morbidity, 130 mortality incidence of, 129 NIMV, HCWs, risk factors, safe application of, technical and infection control measures, technical improvements, research in, 135 nurses caring, 307 personal protection devices, 259 risk components, 259 Simple bottle humidifier, 37, 38 Slowly adapting receptors (SARs), 4 Small nasal masks,

8 370 Index Solid organ transplants, Solid tumors invasive mechanical ventilation, 189 acute respiratory failure, 191 after thoracic surgery, 190 do-not-intubate/palliative-care patients, 192, 193 studies of, 190 Spanish Society of Intensive Care Medicine, 352 Staphylococus aureus, 88 Streptococcus pneumoniae, 100, 101 Swine-origin influenza virus (S-OIV), 311 T Trauma chest trauma, pathophysiology, polytrauma patients (see Polytrauma patients) Tuberculosis, 55 U U.S. Centers for Disease Control and Prevention, 316 V Ventilator-associated pneumonia (VAP) in burn patients incidence, 213 in pediatric ICUs, 212 preventive strategies, 213 heated humidifiers, 42 Vesicants, Viral filters, Vivax malaria, ARDS, pathogenesis of, 112 prevalence of, 112, 116 W Well-ventilated rooms, Wick humidifier, 37, 38 World Health Organization, 316

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