Goldsmith’s Assisted Ventilation of the Neonate
An Evidence-Based Approach to Newborn Respiratory Care
- 7th Edition - December 24, 2021
- Editors: Martin Keszler, Kanekal Gautham, Jay P. Goldsmith
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 7 6 1 7 7 - 2
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 7 6 1 7 8 - 9
A must-have reference for the entire NICU, Goldsmith’s Assisted Ventilation of the Neonate, 7th Edition, is the only fully comprehensive, evidence-based guide to all aspects o… Read more
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Request a sales quoteA must-have reference for the entire NICU, Goldsmith’s Assisted Ventilation of the Neonate, 7th Edition, is the only fully comprehensive, evidence-based guide to all aspects of this fast-changing field. Easy to use and multidisciplinary in scope, this trusted reference provides authoritative guidance on contemporary management of neonatal respiratory diseases, with an emphasis on evidence-based pharmacologic and technologic advances that improve outcomes and quality of life in newborns. It’s an outstanding resource for neonatologists and NICU professionals to acquire new knowledge and techniques in this critical area of neonatal care.
Covers all aspects of both basic and advanced respiratory management of neonates: general principles and concepts; assessment, diagnosis and monitoring methods; therapeutic respiratory interventions; adjunctive interventions; and special situations and outcomes.
Provides updated content on rapidly changing technology and guidelines for assisted ventilation, with up-to-date descriptions of bedside methodologies and the rationale for providing all types of ventilator care in infants.
Contains new chapters on respiratory gas conditioning, diagnosis and management of PPHN, care of the infant with CDH, gaps in knowledge, and future directions.
Includes significant updates on cardiovascular assessment and management, as well as complications of respiratory support.
Provides extensive, full-color visual support with photographs, drawings, charts and diagrams, and radiographic images throughout.
Features more than 30 appendices that help you quickly find normal values, assessment charts, ICU flow charts, procedure steps and other useful, printable forms.
Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
Neonatologists fellows and physicians/Pediatricians
- Cover image
- Title page
- Table of Contents
- Copyright
- Contributors
- Foreword
- Preface
- List of Tables
- List of Illustrations
- Section 1. History, Pulmonary Physiology, and General Considerations
- 1. Introduction and historical aspects
- History of neonatal ventilation: Earliest reports
- Sixteenth and seventeenth centuries
- Eighteenth and nineteenth century
- Twentieth century
- Breakthroughs in ventilation
- Recent advances and outcomes
- Key references
- References
- 2. Physiologic principles
- Basic biochemistry of respiration: Oxygen and energy
- Ontogeny recapitulates phylogeny: A brief overview of developmental anatomy
- Mechanics
- Gas transport
- Oxygenation
- Ventilation
- Perfusion
- Control of ventilation
- Conclusion
- Acknowledgments
- Selected readings
- References
- 3. Control of ventilation
- Introduction
- Pathogenesis of apnea of prematurity
- Genesis of central, mixed, and obstructive apnea
- Relationship between apnea, bradycardia, and desaturation
- Cardiorespiratory events in intubated infants
- Therapeutic approaches
- Long-term consequences of neonatal apnea
- Key references
- References
- 4. Ethical issues in assisted ventilation of the neonate
- Introduction
- An ethical basis for decision making
- Withdrawing and withholding assisted ventilation
- Nonescalation and “heroic measures”
- Moral distress
- Coming to a consensus: When is withholding or withdrawal of assisted ventilation ethically permissible?
- Chronic ventilation and tracheostomy
- Conclusion
- Key references
- References
- 5. Evidence-based respiratory care
- Background
- The technical steps of evidence-based medicine
- Cognitive skills for evidence-based practice
- Translating evidence into practice
- Summary
- Suggested readings
- References
- 6. Quality and safety in respiratory care
- Quality and safety: Background
- Assessing and monitoring the quality of care
- Quality indicators for comparative performance measures
- Quality indicators for improvement
- Improving the quality of care
- The improvement team
- Collaboration
- Aim: What are we trying to accomplish?
- Measurement: How will we know that a change is an improvement?
- What changes can we make that will result in an improvement?
- Plan–do–study–act cycles
- Ensuring the success of quality improvement projects
- Leadership and unit culture
- Why is quality improvement important in neonatal respiratory care?
- Examples of quality and safety improvement in neonatal respiratory care
- Conclusion
- Key references
- References
- 7. Medical and legal aspects of respiratory care
- Disclaimer
- General legal principles
- Supervision of others
- Malpractice
- Malpractice issues specific to neonatology and neonatal respiratory care
- Respiratory failure/mechanical ventilation
- Decreasing the risk of a malpractice lawsuit
- The future of malpractice litigation
- Conclusion
- Key references
- References
- Section 2. Patient Evaluation and Monitoring
- 8. Physical examination
- Historical aspects
- Importance of the physical examination
- Technique of the physical examination
- Interpretation of the findings of physical examination
- Physical examination findings in specific clinical situations
- Conclusion
- Key references
- References
- 9. Imaging: Radiography, lung ultrasound, and other imaging modalities
- Introduction
- Radiation exposure
- Imaging modalities
- Invasive support devices
- Common etiologies of respiratory distress in infants
- Congenital and surgical causes of respiratory distress
- Key references
- References
- 10. Blood gases: Technical aspects and interpretation
- Introduction
- Blood gas physiology
- Techniques for obtaining blood samples
- Choice of monitoring methods
- Blood gas analyzers
- Clinical interpretation of blood gases
- Components of blood gas testing that are measured directly
- Components of blood gas testing that are not measured directly
- Errors in blood gas measurements
- Assessing the accuracy of a blood gas result
- Final thoughts
- Acknowledgment
- Key references
- References
- 11. Noninvasive monitoring of gas exchange
- Noninvasive monitoring of oxygenation
- Noninvasive assessment of partial pressure of carbon dioxide
- Tissue oxygen saturation monitoring using near-infrared spectroscopy
- Conclusion
- Key references
- References
- 12. Pulmonary function and graphics
- Introduction
- Technical aspects
- Respiratory physiology and pathophysiology of respiratory diseases
- Display of respiratory signals
- Display of pulmonary graphics using loops
- Pulmonary mechanics
- End tidal CO2 curve
- Role of pulmonary graphics in daily ventilator management—optimizing ventilator settings
- Pitfalls of graphics monitoring—troubleshooting
- Evidence for the use of respiratory function monitoring to improve neonatal outcome
- Acknowledgments
- Key references
- References
- 13. Airway evaluation: Bronchoscopy, laryngoscopy, and tracheal aspirates
- Introduction
- Flexible nasopharyngolaryngoscopy in the neonate
- Direct microlaryngoscopy and rigid bronchoscopy in the neonate
- Fiberoptic flexible bronchoscopy
- Bronchoalveolar lavage and tracheal aspirates
- Summary
- Suggested readings
- References
- Section 3. Delivery Room Stabilization, Oxygen Therapy, and Respiratory Support
- 14. Delivery room stabilization and respiratory support
- Introduction
- Physiology of transition, asphyxia, and resuscitation
- Anticipation and preparation for resuscitation
- Clinical assessment, apgar score, saturation, and heart rate monitoring
- Intervention basics: Cord clamping, warmth, position, suction, stimulation
- Oxygen
- Ventilation
- Pressure sources
- Interfaces
- Endotracheal intubation
- Intubation equipment and procedure
- Laryngeal mask airway
- Monitoring
- Chest compressions
- Epinephrine
- Volume expansion
- Special cases
- Ethics
- Postresuscitation care
- Key references
- References
- 15. Exogenous surfactant therapy
- History
- Surfactant function, composition, and metabolism
- Types of surfactant
- Acute pulmonary and cardiac effects of surfactant therapy
- Clinical trials of surfactant therapy
- Methods of administration of surfactant
- Choice of surfactant product
- Adverse effects of surfactant therapy
- Economic aspects of surfactant therapy
- Factors affecting the response to surfactant therapy
- Long-term outcomes after surfactant therapy
- Exogenous surfactant therapy for conditions other than respiratory distress syndrome
- Conclusion
- Key references
- References
- 16. Oxygen therapy
- History of the use of oxygen in clinical medicine
- Basic principles of oxygen physiology
- Oxygen in the fetal-to-neonatal transition and postnatal adaptation
- Oxygen saturation in preterm infants with positive pressure ventilation and air
- Oxygen during neonatal care in the neonatal intensive care unit
- Evolving oxygen needs in the first weeks of life and new metabolic indices
- Going home on oxygen
- Oxygen saturation recommendations
- Key references
- References
- 17. Respiratory gas conditioning
- Physiology and pathophysiology
- Standards on humidification of medical gases for use with artificial respiratory support modalities
- Procedures and devices for respiratory gas conditioning
- Estimation and measurement of the efficiency of respiratory gas conditioning device brands
- Key references
- References
- 18. Noninvasive respiratory support
- Introduction
- Continuous positive airway pressure
- Nasal ventilation
- High-frequency nasal ventilation
- Nasal high flow
- Conclusion
- Acknowledgments
- Key references
- References
- 19. Overview of assisted ventilation
- Introduction
- Unique challenges in mechanical ventilation of newborn infants
- Basic ventilator mode classification
- Initiation of mechanical ventilation
- Monitoring and documentation during mechanical ventilation
- Ventilation protocols
- Key references
- References
- 20. Basic modes of synchronized ventilation
- Introduction
- Trigger technology
- Patient-ventilator interactions with synchronized ventilation
- Synchronized intermittent mandatory ventilation
- Choice of assisted ventilation modes
- Guidelines for clinical application
- Conclusion
- Key references
- References
- 21. Principles of lung-protective ventilation
- Introduction
- Neonatal respiratory failure
- Ventilator-induced lung injury
- Lung-protective ventilation: Basic principles
- Lung-protective ventilation: Conventional mechanical ventilation
- Lung-protective ventilation: High-frequency ventilation
- Lung-protective ventilation: Weaning and extubation
- Implications for practice and research
- Key references
- References
- 22. Volume-targeted ventilation
- Rationale for tidal volume-targeted ventilation
- Volume-controlled versus volume-targeted ventilation
- Neonatal tidal volume-targeted ventilation
- Volume guarantee
- Suggested clinical guidelines (see also Table 22.3)
- Pressure-regulated volume control
- Volume ventilation plus
- Volume targeted ventilation/adaptive pressure ventilation
- Targeted tidal volume
- Importance of open lung strategy
- Alarms/troubleshooting
- Conclusion
- Key references
- References
- 23. Special techniques of respiratory support
- Introduction
- Automated control of inspired oxygen
- Ventilation techniques that provide support proportional to patient effort
- Ventilation techniques designed to maintain minute ventilation
- Conclusion
- Key references
- References
- 24. High-frequency ventilation
- Types of high-frequency ventilators
- Evidence base for clinical applications of high-frequency ventilation
- Lung protective strategies with HFV: Limiting pressure while optimizing volume
- Clinical applications of high-frequency ventilation in specific diseases
- Knowledge gaps and research directions
- Summary
- Key references
- References
- 25. Mechanical ventilation: Disease-specific strategies
- Introduction
- Respiratory distress syndrome
- Meconium aspiration syndrome
- Lung hypoplasia disorders
- Bronchopulmonary dysplasia
- Conclusion
- Key references
- References
- 26. Weaning and extubation from mechanical ventilation
- Background
- Weaning from ventilatory support
- Weaning from pressure-controlled ventilation
- Weaning from high-frequency ventilation
- General strategies to facilitate weaning
- Assessment of extubation readiness
- Postextubation management
- Extubation failure
- Summary
- Suggested readings
- References
- 27. Common devices used for mechanical ventilation
- Introduction to ventilators
- Understanding modes of ventilation
- Universal intensive care ventilators used for neonatal ventilation
- Specialized neonatal ventilators
- Summary
- Key references
- References
- 28. Extracorporeal membrane oxygenation
- Introduction
- History of cardiopulmonary bypass
- Development of membrane oxygenators
- Physiology of extracorporeal circulation
- Patient selection
- Technique for beginning extracorporeal membrane oxygenation
- Daily management
- Weaning
- Decannulation
- Outcome
- Key references
- References
- Section 4. Bedside Care, Nutritional and Pharmacologic Support
- 29. Respiratory care of the newborn
- Introduction
- Techniques to provide positive-pressure ventilation
- Noninvasive ventilation and continuous positive airway pressure
- Heated humidified high-flow nasal cannula
- Monitoring during respiratory support
- Humidification and warming during respiratory support
- Airway clearance techniques
- Administration of medications into the respiratory tract
- Clinician-based ventilator and weaning protocols
- Resuscitation and stabilization at delivery
- Key readings
- References
- 30. Nursing care
- Introduction
- Assessment of the neonate
- Pain assessment
- Respiratory care
- General care of the neonate
- Care of the family
- Conclusion
- Key references
- References
- 31. Nutritional support
- The importance of nutrition during critical stages of lung development
- Nutritional requirements
- Parenteral nutrition
- Enteral nutrition
- Special nutritional considerations for infants with established bronchopulmonary dysplasia
- Key references
- References
- 32. Pharmacologic therapies
- Introduction
- Steroids
- Sedation and analgesia
- Muscle relaxants
- Bronchodilators and mucolytic agents
- Diuretics
- Respiratory stimulants
- Summary
- Key readings
- References
- 33. Common hemodynamic problems in the neonate requiring respiratory support
- Introduction
- Normal transition
- Hemodynamic problems in the neonate
- Conclusion
- Key references
- References
- Section 5. Treatment of Specific Conditions, Surgical Interventions and Other Considerations
- 34. Diagnosis and management of persistent pulmonary hypertension of the newborn
- Introduction
- Etiology
- Clinical features
- Hypoxemia in persistent pulmonary hypertension of the newborn
- Echocardiography and hemodynamic assessment in persistent pulmonary hypertension of the newborn20
- Asphyxia, hypothermia, and persistent pulmonary hypertension of the newborn
- Surfactants in persistent pulmonary hypertension of the newborn
- Inhaled nitric oxide
- Sildenafil
- Milrinone
- Prostaglandin E1
- Endothelin receptor antagonists
- Management of systemic hypotension in persistent pulmonary hypertension of the newborn
- Preterm infants with early pulmonary hypertension (preterm persistent pulmonary hypertension of the newborn)
- Conclusion
- Key references
- References
- 35. Care of the infant with congenital diaphragmatic hernia
- Introduction
- Antenatal assessment of severity and fetal management
- Initial treatment and procedures in the delivery room
- Transport from delivery room to neonatal intensive care unit
- Initial ventilation in congenital diaphragmatic hernia
- Gentle ventilation in congenital diaphragmatic hernia
- Supportive measures
- Pulmonary vasodilator therapy
- Extracorporeal membrane oxygenation
- Surgical repair
- Pulmonary and nutritional outcome
- Discharge and follow-up
- Conclusion
- Acknowledgment
- Key references
- References
- 36. Management of the infant with bronchopulmonary dysplasia
- Introduction
- Epidemiology, pathophysiology, and diagnosis of bronchopulmonary dysplasia
- Prevention of bronchopulmonary dysplasia
- Clinical presentation and evaluation of infants with established bronchopulmonary dysplasia
- Physiologic basis for respiratory support in infants with established bronchopulmonary dysplasia
- Management of infants with established bronchopulmonary dysplasia
- Adjunctive respiratory support therapies in infants with established bronchopulmonary dysplasia
- Pulmonary outcomes in infants with bronchopulmonary dysplasia
- Conclusion
- Selected readings
- References
- 37. Medical and surgical interventions for respiratory distress and airway management
- Introduction
- Medical management of the neonatal airway
- Anatomic disadvantages of the neonatal airway
- Medical management of neonates with common respiratory disorders requiring surgical intervention
- Surgical management of the neonatal airway
- The pediatric surgeon/otolaryngologist as diagnostician and therapist
- The pediatric surgeon/otolaryngologist as consultant
- Key references
- References
- 38. Intraoperative management of the neonate
- Transitional physiology and pulmonary hypertension
- Pulmonary development and lung injury
- Anatomic considerations
- Location of operation
- Operative management
- Additional operative considerations
- Conclusion
- Key references
- References
- Section 6. Complications of Respiratory Support, Special Considerations, and Outcomes
- 39. Complications of respiratory support
- Complications of respiratory support
- Mechanical ventilation
- Endotracheal intubation
- Unplanned extubation
- Ventilator-induced lung injury
- Ventilator-associated pneumonia
- Ventilator-associated events and ventilator-associated conditions
- Noninvasive respiratory support
- Suggested readings
- References
- 40. Neonatal respiratory care in resource-limited countries
- Introduction
- Scope of the need
- Limiting factors
- Current status
- Establishing respiratory care programs
- Outcomes of neonatal ventilation
- Projected growth in neonatal ventilation: A global perspective
- Ethical dilemmas
- Conclusion
- Acknowledgment
- Key references
- References
- 41. Transport of the ventilated infant
- Important role of the transport team
- Regionalized care
- Transport team composition
- Transport education
- Transport physiology
- Stabilization
- Clinical issues
- Equipment
- Future directions
- Key references
- References
- 42. Discharge and transition to home care
- Factors to consider when determining readiness for discharge
- Discharge team
- Predischarge needs assessment
- Home environment
- Equipment and supplies
- Personnel resources
- Home nursing
- Emergency planning
- Postdischarge follow-up
- Tracheostomy care
- Changing tracheostomy tubes
- Outpatient management of supplemental oxygen therapy
- Indications for home oxygen therapy
- Oxygen delivery systems for home oxygen therapy
- Strategies for discontinuation of home oxygen therapy
- Key references
- References
- 43. Neurologic effects of respiratory support in the neonatal intensive care unit
- Introduction
- Cerebral blood flow in the neonate
- Brain injury in the preterm infant
- Influence of oxygen concentration and carbon dioxide on cerebral blood flow
- Mode of ventilation and brain injury
- Medications used to treat respiratory conditions
- Summary
- Key references
- References
- 44. Pulmonary and neurodevelopmental outcomes following ventilation
- Introduction
- Incidence and definitions of bronchopulmonary dysplasia
- Pulmonary outcomes
- Health care utilization
- Neurodevelopmental outcomes of preterm infants with bronchopulmonary dysplasia
- Outcomes after neonatal hypoxic respiratory failure
- Conclusion
- Key references
- References
- 45. Gaps in knowledge and future directions for research
- Introduction
- Development and application of new methods of generating knowledge
- Respiratory care
- Management of specific respiratory and nonrespiratory conditions requiring assisted ventilation
- Ancillary support
- Development of devices
- Current research
- Concluding comments
- Selected readings
- References
- Appendices
- Index
- No. of pages: 655
- Language: English
- Edition: 7
- Published: December 24, 2021
- Imprint: Elsevier
- Hardback ISBN: 9780323761772
- eBook ISBN: 9780323761789
MK
Martin Keszler
Affiliations and expertise
Professor of Pediatrics, Alpert Medical School of Brown University and Associate Director of NICU and Director of Respiratory Services, Women and Infants Hospital of Rhode Island, Providence, Rhode IslandKG
Kanekal Gautham
Affiliations and expertise
Chair of Pediatrics and the Pediatrician-in-Chief, Nemours Children’s HospitalJG
Jay P. Goldsmith
Affiliations and expertise
Professor, Department of Pediatrics, Tulane University, Metairie, LouisianaRead Goldsmith’s Assisted Ventilation of the Neonate on ScienceDirect