Page 21 - Clinical Application of Mechanical Ventilation

Contents XIX

Ventilator-Associated Pneumonia 399
Fluid Balance 400
Distribution of Body Water 400
Clinical Signs of Extracellular Fluid Deficit or Excess 401
Treatment of Extracellular Fluid Abnormalities 402
Electrolyte Balance 402
Normal Electrolyte Balance 402
Sodium Abnormalities 403
Potassium Abnormalities 404
Nutrition 405
Undernutrition 405
Overfeeding 406
Low-Carbohydrate High-Fat Diet 406
Total Caloric Requirements 407
Phosphate Supplement 407
Adjunctive Management Strategies 408
Low Tidal Volume 408
Prone Positioning 409
Tracheal Gas Insufflation 410
Summary 411
Self-Assessment Questions 412
Answers to Self-Assessment Questions 415
References 415
Additional Resources 419

Chapter 13: pharMaCotherapy for MeChaniCal Ventilation

Introduction 421
Drugs for Improving Ventilation 422
Autonomic Nervous System Agents 422
Adrenergic Bronchodilators (Sympathomimetics) 423
Anticholinergic Bronchodilators (Parasympatholytics) 426
Xanthine Bronchodilators 427
Anti-Inflammatory Agents (Corticosteroids) 429
Delivery of MDI Medications 430
Neuromuscular Blocking Agents 431
Mechanism of Action 432
Characteristics of Neuromuscular Blocking Agents 433
Factors Affecting Neuromuscular Blockade 433
Adverse Effects 436
Evaluation of Neuromuscular Blockade 437
Central Nervous System Agents 439
Sedatives and Antianxiety Agents (Benzodiazepines) 440
Opioid Analgesics 442
Agents for Seizures and Elevated Intracranial Pressure (Barbiturates) 447

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