This book provides readers with a comprehensive and up-to-date guide to non-invasive mechanical ventilation in palliative medicine, focusing on why and when it may be necessary. Physicians will find a practical guide to this specific context, particularly focused on pulmonary function and physiology in the elderly, and on ventilatory management in surgery and chronic stable conditions. The book provides detailed information on the rationale for invasive and non-invasive ventilation, the different modes of ventilation, indications and contraindications, prognostic factors, and outcomes. It addresses in detail the role of postoperative mechanical ventilation following various forms of surgery, and discusses key aspects of withdrawal from ventilatory support. Attention is also devoted to the use of mechanical ventilation within and beyond the ICU. The concluding part of the book focuses on important topics such as ethics, legal issues, home mechanical ventilation, drug therapy, rehabilitation and end-of-life. Its multidisciplinary approach, bringing together contributions from international experts in different specialties, ensures that the book will be of interest to a broad range of health professionals involved in the management of older patients admitted to the ICU, including intensivists, anesthesiologists, and geriatricians.

This book aims to highlight the importance of the development of health conditions and demand for the application of noninvasive mechanical ventilation (NIMV) outside the intensive care units (ICUs); the diversification of possible scenarios outside the ICUs; the need to establish references that consolidate this phenomenon and the healthcare organizations models. In the last decades the extension of the use of NIMV outside of the ICUs has led to the generation of protocols and to the creation of new in-hospital care models. In this field, the main determining factors are a better knowledge of technique, technological advancement, better monitoring capacity, the creation of multidisciplinary teams adequately trained in their application, and social and health events that have overloaded ICUs. All these elements have promoted the creation of these NIMV units outside ICUs. This new reality entails the need for clarification of concepts, recommendations, and analysis of how to plan NIMV. Although the literature that clearly determine the indications and aids on the use of NIMV is considerable, this volume, pointing out the diversity of different healthcare models to define how to organize NIMV outside the ICUs, shed a light and bring a clear benefit to the scientific community involved. The book is structured in eleven main sections analyzing the epidemiology and trends for NIMV healthcare models and determining factors for these models outside ICUs. The originality of the work, its clear clinical-practical impact and the multidisciplinary approach given by all healthcare professionals involved (intensivists, pneumologists, internal medicine and emergency medicine specialists, geriatricians, chest respiratory therapists, etc.) is very relevant for the thoroughness of the book.

This book describes the issues and challenges that clinicians encountered in the management of older critically ill patients during the Covid-19 pandemic, and offers practical information on how to manage them. Older adults are more susceptible to complications such as acute respiratory distress syndrome (ARDS) as a result of viral pneumonia. In addition, they often have multiple comorbidities and are commonly frail, which means their various organs and systems, such as the respiratory system, have reduced functional reserves. As such, older adults are less able to react to acute stressors. During the current Covid-19 pandemic, older adult patients' mortality is increased. Further, the infection and death rates of elderly people in nursing homes and health care institutions are high. Management of older adults with Covid is complicated. The reduced availability of beds may limit their access to ICU. Moreover, the prognosis may be poor, and airway management and ventilation strategies have to take into account various clinical and physiological characteristics specific to older patients. This book is addressed to all allied professionals involved in the management of older critically ill patients and presents information collected and practical lessons learned from the clinical daily management of this population during the pandemic.

The second edition of this book describes the clinical indications of NIV in patients hospitalized with high-risk infections as well as in the prehospital management of mass casualty incidents, including chemical or biological disasters and pandemics. In recent decades, we have learned the impact that different pandemics and mass casualty disasters can outcome in terms of health resource use, health costs and human lives. The development of respiratory failure in these patients, either infectious or non-infectious causes, has led to develop employment plans related both to invasive or noninvasive mechanical ventilation during acute respiratory failure. In this book authors evaluate a rational basis for indications, specific noninvasive mechanical ventilation indications in hospitalized patients (tuberculosis, bacterial, virus, etc.) and prehospital applications (mass casualty: chemical, biological disaster), equipment (ventilators, interfaces) and plan organization for health systems: how and when apply NIV. A critical review of already published studies is described as well as implications and how will be the future according to international expert opinions. Therefore, this updated edition represents a useful scientific reference point according to what it has been experienced in the last pandemics, with respect to the growing role that NIV has and must have in the world.

As old age is increasing globally, some challenges arise such as multimorbidity, a unique medical condition that has multiple potential complications and thus needs high-quality care directed by qualified healthcare providers. Multimorbidity is an important daily challenge to internists worldwide due to its many difficulties. Junior physicians dealing with multimorbidity must have the knowledge to practice high-quality care for their elderly patients. Cases on Multimorbidity and Its Impact on Elderly Patients considers approaches to manage multimorbidity and its unique complications and challenges to aid in appropriate daily decision making. Covering key topics such as weight loss, aging, and frailty, this reference work is ideal for medical professionals, nurses, policymakers, researchers, scholars, academicians, practitioners, instructors, and students.

In different sections of this book the relationships between the patterns of psychological response in acute and chronic respiratory failure, as well as the epidemiology of neuropsychiatric disorders in ventilator management, are collected and analyzed. Main concepts such as “vulnerability to stress”, critical illness-psychological stress and susceptibility that may develop during NIV support, as well as the diagnosis of neuropsychiatric disorders in respiratory failure are also summarized. A section is devoted to the most frequent indications of NIV, also including a special use of NIV in pandemic and high-risk infections, as well as in several other conditions such as acute and chronic respiratory failures and neurological disorders. A summary of practical approaches for treatment and prevention in neurologic and psychiatric disorders during noninvasive mechanical ventilation, as well as the perspective in terms of outcomes, quality-of-life, palliative care is also given. The book is intended for all those healthcare professionals treating patients suffering from neurological or psychiatric disorders and who develop acute or chronic respiratory failure. Neurologists, psychiatrists, pulmonary critical care professionals, geriatricians, internists and psychologists will find in the book a valuable guide for their everyday clinical practice.