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Ventilatory Support for Chronic Respiratory Failure

Y. Adir
European Respiratory Review 2009 18: 306; DOI:
Y. Adir
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Edited by N. Ambrosino and R.S. Goldstein
Published by Informa Healthcare
Pages: 640. Price: £150. ISBN: 978‐0849384981

Chronic respiratory failure has become a global issue because patients with chronic conditions that affect the respiratory system are now surviving for longer. In parallel, the advances in the management of patients with acute respiratory failure and in the technical aspects of life support have led to an increasing number of patients with chronic respiratory failure who become dependent on long‐term mechanical ventilation for their survival.

This book is designed to address the need for information on long‐term ventilation in chronic respiratory failure. It begins with an introduction, which emphasises the pathophysiology and principles of positive pressure ventilation. The book then goes on to discuss the various causes of difficult weaning, including the mechanisms involved. Following this section, weaning protocols, weaning in specialised facilities and rehabilitation in the ICU are then described. The book follows the patient from the ICU, through the different specialised units within the hospital, into the community and finally to the patient's home. The rationale and indications for noninvasive ventilatory support in obstructive and restrictive disorders, the technical issues of the different devices and how to train the home‐health team are all covered in detail.

Another section focuses on the important topic of caring for patients with chronic respiratory failure. Pharmacological treatment, treatment of respiratory infections, the patient‐ventilator interface, trachestomy weaning, management of secretion clearance and approaches used for malnourished patients are discussed. Separate chapters discuss the management of chronic respiratory failure in different patient groups, such as patients with neuromuscular disease.

The textbook pays special attention to the important topics of quality of life, the psychological aspects of patients with chronic respiratory failure, end of life decisions and ethical issues. In addition, there is a comprehensive discussion on the perspective of the patients, family and caregivers, the physician and other allied healthcare personnel, highlighting the importance of the relationships between the patients and the healthcare personnel, and the understanding of the disease by the patient and their family.

The final section covers the worldwide approach to long‐term ventilation, encompassing perspectives from Europe, North America, South America and Asia.

In summary, this is a comprehensive book written by wellknown experts in the field and contributes to the existing knowledge chronic respiratory failure. Clinicians involved in the care of such patients will find this book a complete and practical resource on “how to apply” and monitor ventilatory support in patients with chronic respiratory failure.

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    Ventilatory Support for Chronic Respiratory Failure
    Y. Adir
    European Respiratory Review Dec 2009, 18 (114) 306;

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    Ventilatory Support for Chronic Respiratory Failure
    Y. Adir
    European Respiratory Review Dec 2009, 18 (114) 306;
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