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Doody's Review ServiceReviewer: Loutfi S. Aboussouan, MD, FCCP (Wayne State University)
Description: This is a superb and timely reference book on long-term mechanical ventilation, approaching the topic from clinical, ethical, and reimbursement angles.
Purpose: The book provides a comprehensive and up-to-date reference on pathophysiology, clinical management, and reimbursement practices for long-term mechanical ventilation. These goals are largely met.
Audience: Although the intended audience is clinicians and reimbursement specialists, the interested audience could readily be expanded to include pulmonologists or intensivists, respiratory therapists, neurologists, and nursing and rehabilitation specialists. Recognized authorities assembled from several countries contributed to this work.
Features: The topic is addressed from several angles, including epidemiology, pathophysiology, management issues related to the application of long-term ventilation in children or in patients with specific diseases, rehabilitation, and long-term outcome. An interesting and useful feature is the author index encompassing all authors cited in the references. Shortcomings are minor and include incomplete references in one chapter. Also lacking is a short discussion on ethical considerations from the perspective of the patients, caregivers, and physicians. Such a discussion would be important to assist in preliminary discussions with patients with progressive neuromuscular diseases expected to lead to ventilatory failure.
Assessment: This book will occupy a prominent place on the shelf of any interested reader. The wide coverage of the topic is likely to make it a frequently consulted reference. It differs from other books on mechanical ventilation in its special emphasis on the long-term perspective and its coverage of noninvasive ventilation options. A marked increase in the number of patients requiring such interventions, coupled with significant questions regarding the management and disposition of such patients, make this a much needed and timely book. Throughout the book equal emphasis is placed on noninvasive positive pressure ventilation, highlighting this technique's increasing role in long-term ventilation.