Artificial Ventilation: A Basic Clinical Guide.

Abstract

Due to the coronavirus disease 2019 (COVID-19) crisis, the need for easily understandable information on respiratory physiology is greater than ever. Health care facilities around the globe must provide adequate support for patients whose breathing is compromised. In 2020, billions of dollars were spent on the rapid production of ventilators that conform to newly developed guidelines defining minimal technical requirements.1 At the same time, teams made up of staff from highly diverse backgrounds need a readily available resource covering the basic principles of ventilator support. This will allow the creation of shared mental models based on adequate theoretical understanding and provide the foundation for excellent patient care. The second edition of Artificial Ventilation: A Basic Clinical Guide is aimed at the nonspecialist reader and closes the gap between prehospital care and the highly specialized setting of a modern intensive care unit (ICU). The revised edition includes a chapter on mass ventilation, including lessons learned from the recent severe acute respiratory syndrome (SARS) COVID-19 pandemic, and covers international approaches with differing strategies. The book provides staff with a basic understanding of the principles of physiology and externally controlled breathing. Moreover, it addresses the support of unstable patients suffering from severe conditions of tremendous clinical relevance, such as the acute respiratory distress syndrome (ARDS). With the revision of this book addressing a commonly covered topic, Baker has found a niche. The book begins with interesting facts about the historical development of artificial ventilation, then continues with key anatomic, physiologic, and pathophysiologic concepts. The contents follow a uniform, structured approach that allows readers to follow along easily. The second part of the book focuses on special patient populations and circumstances, such as extreme environments. The chapters on the ICU and mass ventilation offer more in-depth knowledge while still addressing the targeted audience without a specialist background. Each chapter has a concise structure, with a short introduction, sometimes including overviews of the information to be discussed in the following subsections. The Appendix is organized in the same way, providing additional material for the beginner as well as the highly skilled reader. A noteworthy number of info boxes and figures highlight and illustrate some important concepts, and question-style paragraphs keep the reader actively involved. Answers organized in numerical lists allow for straightforward information gathered in a refreshing way. Finally, the concluding abstract at the end of each chapter gives a great overview of the content and helps the reader to quickly find the exact subject of interest. References after the mini conclusions appear as suggestions for further reading, encouraging the more advanced reader to go into more detail if desired. A print book with the same content as the digital version is available at a higher price. The eBook includes references that transfer directly to other chapters and primary sources. A new chapter “Mass ventilation” covers the most pertinent recent literature on SARS COVID-19. It also addresses technical topics, such as the pathophysiology and management of ARDS and potential advances such as “low-elastance (L) and high-elastance (H)-type ventilation and organizational issues in times of crisis. The book provides additional value to the first edition. The last chapter is the only part worth criticizing. It aims to give the reader a denser summary of the most important topics in the book, but since the whole manuscript is already very well structured, and the rather complex topic is kept short and simple, this chapter does not appear to be a great addition. Omitting this last chapter in favor of incorporating an update on new evidence from the ongoing crisis might be worth contemplating for a future edition. Overall, the textbook is very concise, but still covers a broad selection of important topics and key concepts. Some highlights include very up-to-date information on lung injury from SARS COVID-19 and strategic plans used in this recent crisis. In comparison to similar books, this is a quick guide, aimed to provide structured information for the nonspecialist and to fill the gap between prehospital and high-end institutional care. The book is ideal for knowledge acquisition as well as revision―even for advanced trainees and specialists―and can be highly recommended for all staff members providing care in the current crisis. Corina Bello, MDDepartment of Anesthesiology and Intensive CareSpitalregion GrabsGrabs, Switzerland[email protected] Markus M. Luedi, MD, MBADepartment of AnaesthesiologyInselspitalBern University HospitalUniversity of BernBern, Switzerland[email protected]