Description
This book puts forward a comprehensive text that addresses routine uses of oxygen as a therapeutic modality as well as utilization of supplemental oxygen and advanced support of academic respiratory failure in the sickest patients with hypoxemia seeking care in medical centers. These centers range from rural or safety net hospitals to the most advanced academic medical centers. Oxygen supplementation may be one of the most commonly applied therapeutic modalities utilized in modern medicine. Despite this, a comprehensive discussion of the practical application of supplemental oxygen has often been limited to treatises that deal with the very advanced forms lung disease without educating the reader on the basics of oxygen in human physiology and the full spectrum of human illnesses that compromise oxygen delivery to the host. As highlighted by the recent pandemic, there are growing number of tools to improve oxygenation.
The authors cover both harmful effects of oxygen delivery, beneficial effects, and a careful description of the risks and benefits to understand when advanced techniques can be life-saving and when they should be avoided. In 2018, a meta-analysis addressed the use of simple supplemental oxygen in a number of routine diagnoses including pneumonia, myocardial infarction, sepsis and stroke. The authors put this very important background into context for the modern physician guiding them on the appropriate use of oxygen to avoid the pitfall of increasing mortality without affecting important patient outcomes. Every practicing physician should be aware of the benefits of oxygen therapy, but must also understand the harms and how to avoid overuse.
Beyond routine therapeutics, the authors review the use of oxygen in SCUBA and mountaineering so that the recreational enthusiast and the physician treating such individuals can be ready to understand the pathophysiology and therapeutic options available to the clinician. The authors also include chapters covering special disease states such as sleep apnea, carbon dioxide poisoning and methemoglobinemia to understand how these conditions can reduce oxygen delivery and lead to significant morbidity and even mortality.
This is an ideal guide for all medical professionals who use oxygen to treat and help their patients.
Part I: Origins and Discovery of Oxygen.- The Emergence of Oxygen on Earth.- The genius of Joseph Priestly; the discovery of oxygen as a component of air.- "We are all on fire"; understanding the biochemistry of human metabolism including aerobic and anaerobic pathways for generating energy.- How aerobic and anaerobic metabolism enables new imaging techniques (such as PET scanning).- Part II: The Physiology of Respiration.- The Gas Laws.- First therapeutic use of supplemental oxygen in modern medicine.- Do no harm; understanding the limits and the pitfalls of using supplemental oxygen.- Fundamentals of using oxygen via nasal cannula in health and disease.- Hemoglobin; the ideal conveyor of oxygen.- A deadly snowfall in the city: carbon dioxide poisoning and hyperbaric oxygen.- Methemoglobinemia: how changes in hemoglobin structure can alter oxygen carrying.- Control of Breathing.- Part III: Chronic Respiratory Failure.- Principles of outpatient oxygen use for patients with chronic lung diseases including COPD and pulmonary fibrosis.- How to Prescribe oxygen for outpatient use.- Use of Oxygen after Lung Surgery.- High Flow Nasal Cannula.- Non- invasive ventilation.- The supply side: commercial supplies of oxygen.- A deadly sleep: Obstructive Sleep Apnea and Hypoxemia.- Chronic Use of Tracheostomy Tubes.- Use of Oxygen at the end of Life.- Part IV: Acute Respiratory Failure.- Basic Principles of Mechanical Ventilation.- The Endotracheal Tube.- Complications of Mechanical Ventilation.- Treatment of Pneumothorax.-Managing Respiratory Failure in Pneumonia and ARDS.- Use of Prone Positioning in Pneumonia and ARDS including COVID 19.- Complications of Prone Positioning.- When All Else Fails: Principles extracorporeal membrane oxygenation (ECMO).- ECMO in the time of Pandemics.- Tracheostomy in the ICU.- Ethics of Life-sustaining care and withdrawing mechanical ventilation in the ICU.- Part V: Lung Recovery.- Tincture of time: Recovery of the Lung after injury.- Pulmonary rehabilitation.- Long Term Respiratory Failure.- Lung Transplant.- Part VI: Special Physiological Circumstances.- Under the sea: principles of SCUBA.- Ascent into thin air; how oxygen is reduced at elevation due to low barometric pressure.- Cardiopulmonary Bypass.- Part VII: Conclusions.- Future of lung support.- The search for oxygen in the solar system.- Conclusions.
Gregory C Kane MD, MACP is The Jane and Leonard Korman Professor of Medicine and Chair of the Department of Medicine at Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
Michael Baram, MD is Professor of Medicine and Director of Hospital Based Clinical Research Team at Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
Urvashi Vaid, MD, MS is Associate Professor of Medicine and Director of Phase 1 Medical Student Education, at Jefferson/ National Jewish Health, Korman Respiratory Institute and Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
