Murray & Nadel's Textbook of Respiratory Medicine, 2-Volume Set, 6e

Murray & Nadel’s Textbook of Respiratory Medicine......Page 2
Copyright page......Page 3
Dedication for Sixth Edition......Page 4
Contributors......Page 5
Preface to the Sixth Edition......Page 19
Preface to the First Edition......Page 20
Videos......Page 21
Gross and Subgross Organization......Page 26
Airways......Page 29
Pulmonary Circulation......Page 32
Terminal Respiratory Units......Page 35
Innervation......Page 39
The Pleural Space  and Pleuras......Page 40
Comparison of the Lung of Mice and Humans......Page 42
Key Readings......Page 44
References......Page 45
Stages of Lung Development......Page 50
Tissue Interactions and  Lung Development......Page 53
Retinoic Acid......Page 54
Wnts and β-Catenin......Page 55
NKX2-1......Page 56
Posttranscriptional Gene Regulation in Lung Development......Page 57
Key Readings......Page 59
References......Page 60
Introduction......Page 64
Genomic Maps......Page 65
Public Databases......Page 67
Association Studies......Page 68
Epigenetics......Page 69
Acute Respiratory Distress Syndrome......Page 72
Lung Cancer......Page 73
Fibrosing Idiopathic Interstitial Pneumonia......Page 74
Key Readings......Page 75
References......Page 76
Ventilation......Page 79
Functional Residual Capacity, Residual Volume, and Total Lung Capacity......Page 80
Alveolar Ventilation......Page 81
Physiologic Dead Space......Page 82
Nontopographic Inequality......Page 83
Pressure Inside Blood Vessels......Page 84
Pulmonary Vascular Resistance......Page 85
Pressure-Flow Relations......Page 86
Effect of Lung Volume......Page 87
Three-Zone Model for the Distribution  of Blood Flow......Page 88
Other Factors Affecting the Distribution  of Blood Flow......Page 89
Hypoxic Pulmonary Vasoconstriction......Page 90
Nonrespiratory Functions of  the Pulmonary Circulation......Page 92
Oxygen......Page 93
Carbon Dioxide......Page 94
Gas Exchange......Page 95
Hypoventilation......Page 96
Oxygen Uptake along the Pulmonary Capillary......Page 98
Diffusing Capacity......Page 99
Shunt......Page 101
Gas Exchange in a Single Lung Unit......Page 102
Pattern in the Normal Lung......Page 103
Traditional Assessment of  Ventilation-Perfusion Inequality......Page 104
Distributions of Ventilation-Perfusion Ratios......Page 105
Multiple Inert Gas Elimination Technique.......Page 106
Distributions in Lung Disease.......Page 107
Ventilation-Perfusion Inequality and Carbon Dioxide Retention......Page 108
Oxygen Sensing......Page 109
Key Readings......Page 110
References......Page 111
Volume......Page 114
The Combined Gas Law......Page 115
Elastic Recoil of the Lungs......Page 116
Hysteresis and Stress Adaptation......Page 117
Respiratory Muscles see Chapter 97......Page 118
Fatigue of Respiratory Muscles......Page 119
Integration of Lung and Chest  Wall Mechanics......Page 120
The Impact of Positive End-Expiratory Pressure on Pleural Pressure......Page 121
Laminar versus Turbulent Flow......Page 122
Flow Limitation......Page 124
The Bernoulli Effect and Wave Speed Theory.......Page 125
Intrinsic PEEP during Positive-Pressure Ventilation of COPD......Page 126
Measurement of Static Compliance and Resistance during Mechanical Ventilation......Page 127
Measuring Work of Breathing in a Spontaneously Breathing Patient......Page 128
Key Readings......Page 129
eFigure Image Gallery......Page 130
References......Page 132
Pulmonary Vascular Pressures......Page 134
General Design......Page 135
Blood-Gas Interface......Page 136
Imaging the Pulmonary Circulation......Page 137
Pulmonary Vascular Resistance......Page 138
Lung Volume.......Page 139
Pulmonary Vascular Pressure-Volume Curve......Page 140
Mechanical Stress and the  Lung Circulation......Page 141
Cyclic Stretch......Page 142
Response Elements......Page 143
Transcapillary Exchange and the Fluid Flux Equation......Page 145
Capillary Endothelium......Page 146
Alveolar Epithelium......Page 147
Interstitial Compliance......Page 148
Pulmonary Capillary Pressure and Plasma Osmotic Pressure in Edema Formation......Page 149
Regional Differences in Endothelial Permeability......Page 150
Cytoskeletal Alterations......Page 151
Endothelial Water Permeability and  Albumin Transcytosis......Page 152
Strategies to Reverse Permeability  and Restore Barrier Integrity......Page 153
Key Readings......Page 154
eFigure Image Gallery......Page 155
References......Page 158
Conjugate Acids and Bases......Page 166
Measurements......Page 167
Bicarbonate......Page 168
Base Excess......Page 169
Role of the Kidneys......Page 170
Nomenclature of Acid-Base Disorders......Page 171
Anion Gap Concept......Page 173
Lactic Acidosis......Page 175
Diabetic Ketoacidosis......Page 177
Type 1 Renal Tubular Acidosis.......Page 179
Type 2 Renal Tubular Acidosis.......Page 180
Urine Net Charge and Osmolar Gap......Page 181
Therapy......Page 182
Mechanical Ventilation......Page 183
Therapy......Page 184
Clinical Manifestations......Page 185
Causes......Page 186
Key Readings......Page 187
References......Page 189
Introduction......Page 191
Alveolar Type I Cells......Page 192
Alveolar Type II Cells......Page 195
Physiologic Functions of Pulmonary Surfactant......Page 197
Composition and Pool Sizes......Page 198
Surfactant Protein A......Page 199
Surfactant Protein B......Page 200
Surfactant Protein D......Page 201
Secretion and Extracellular Processing of Surfactant......Page 202
Primary Surfactant Deficiency of  the Newborn......Page 203
Interstitial Lung Diseases......Page 204
Key Readings......Page 205
References......Page 207
Evidence for Active Fluid Transport in the Intact Lung......Page 212
Ion Transport in Alveolar and Distal Airway  Epithelial Cells......Page 213
Regulation of Lung Epithelial Fluid Transport......Page 215
Mechanisms That Can  Impair the Resolution  of Alveolar Edema......Page 216
Alveolar Fluid Transport Under Pathologic Conditions......Page 217
Key Readings......Page 218
References......Page 219
Normal Airway Mucins......Page 221
Manifestations of Mucous Hypersecretion Depend on  Airway Location......Page 222
Importance of Mucous Hypersecretion in  Chronic Inflammatory Airway Diseases......Page 223
Cystic Fibrosis see Chapter 47......Page 224
Asthma see Chapters 41 and 42......Page 225
Chronic Bronchitis and COPD see Chapters 43 and 44......Page 226
Roles of Reactive Oxygen Species in Airway Epithelial Mucin Production......Page 227
Toll-like Receptors......Page 228
GPCR Can Exaggerate EGFR-Dependent  Mucin Production......Page 229
Mucus Biology: Present Status and Future Opportunities......Page 230
Key Readings......Page 231
References......Page 232
Definition and Description of an Aerosol......Page 235
Evaluation of Aerosol Particle Size......Page 236
Pressurized Metered-Dose Inhalers......Page 237
The Inhaled Mass......Page 238
Deposition......Page 239
Control of Breathing Pattern and Aerosol Deposition......Page 240
Asthma......Page 241
Delivery of Inhaled Medications to Young Children......Page 243
Aerosol Delivery during  Mechanical Ventilation......Page 245
Mucociliary Clearance  and Disease......Page 246
Toxins......Page 247
Infectious Aerosols......Page 248
Key Readings......Page 250
References......Page 251
Overview of the Components of Lung Innate Immunity......Page 253
Pentraxins and Other Secreted Pattern Recognition Receptors......Page 256
C-Type Lectin Receptors.......Page 258
Summary......Page 260
Epithelium......Page 261
Polymorphonuclear Leukocytes......Page 262
Mononuclear Phagocytes......Page 264
Functions of Resident and Interstitial Alveolar Macrophages.......Page 266
Functions of Recruited Monocytes and Macrophages.......Page 267
Mouse and Human Lung Dendritic Cell Subsets.......Page 270
Functions of Lung Dendritic Cells.......Page 272
System Integration......Page 273
Key Readings......Page 274
References......Page 275
Components of the Immune System: Overview......Page 282
Structure of Immunoglobulin and the B-Cell Receptor for Antigen......Page 284
Formation of the B-Cell Receptor Repertoire......Page 285
Isotype Switching and Function of the Different Immunoglobulin Classes......Page 286
B-Cell Development......Page 287
T-Cell Receptor Structure and T-Cell Receptor Repertoire Formation......Page 288
Antigen-Presenting Cells and the Major Histocompatibility Complex......Page 289
Presentation and T-Cell Recognition of Antigens......Page 290
T-Cell Tolerance: Prevention of Self-Reactivity......Page 291
T-Cell Activation and Co-Stimulation......Page 292
Subsets of T Helper Cells......Page 293
CD4+ T-Cell?B-Cell Collaboration and Regulation of Antibody Production......Page 294
Lymphocyte Populations and Trafficking in the Lung......Page 295
Immune Response to Autoantigens......Page 297
Granulomatous Lung Disease......Page 298
Key Readings......Page 299
eFigure Image Gallery......Page 300
References......Page 304
Lung Cancer......Page 307
Invasive Adenocarcinoma.......Page 309
Adenocarcinoma Variants.......Page 310
TNM Staging: Potential Changes According to New Classification......Page 311
EGFR Mutation Testing......Page 313
Use of Minimal Stains to Maximize Tissue for Molecular Testing......Page 314
Small Cell Carcinoma......Page 315
Combined SCLC.......Page 316
Typical and Atypical Carcinoid......Page 317
Large Cell Carcinoma......Page 318
Solitary Fibrous Tumor......Page 319
Idiopathic Interstitial Pneumonias......Page 320
Usual Interstitial Pneumonia/Idiopathic Pulmonary Fibrosis.......Page 321
Nonspecific Interstitial Pneumonia.......Page 323
Organizing Pneumonia/Cryptogenic Organizing Pneumonia.......Page 324
Diffuse Alveolar Damage/Acute Interstitial Pneumonia.......Page 325
Lymphocytic Interstitial Pneumonia.......Page 326
Rare Histologic Patterns.......Page 327
Hypersensitivity Pneumonitis......Page 328
Sarcoidosis......Page 329
Pulmonary Langerhans Cell Histiocytosis......Page 330
Lymphangioleiomyomatosis......Page 331
Eosinophilic Pneumonia......Page 332
Pulmonary Hypertension......Page 333
eFigure Image Gallery......Page 336
Key Readings......Page 335
References......Page 338
Lung Injury......Page 343
Epithelial Repair......Page 346
Cell Spreading and Migration......Page 347
Resolution of Inflammation......Page 348
Tissue-Specific Stem Cells......Page 349
Loss of Regenerative Potential: Depletion of the Facultative Progenitor Cell Pool......Page 350
Does Lung Repair Recapitulate Lung Development?......Page 351
Key Readings......Page 352
References......Page 353
Introduction......Page 362
Communication Skills......Page 363
Dyspnea......Page 364
Clinical Features.......Page 365
Clinical Features.......Page 366
Occupational History......Page 367
Inspection......Page 368
Palpation......Page 369
Auscultation......Page 370
Continuous Sounds Wheezes......Page 371
Interpretation......Page 372
Clubbing......Page 373
Other Extrapulmonary Associations......Page 374
Key Readings......Page 381
References......Page 382
Infection Prevention......Page 384
Specimen Selection, Collection,  and Transport......Page 385
Specimen Adequacy......Page 389
Microbiologic Assays......Page 390
Microscopy......Page 392
Culture......Page 395
Antimicrobial Susceptibility Testing......Page 398
Nucleic Acid Tests......Page 399
Antigen Testing......Page 401
Serologic Testing and Interferon-γ Release Assays......Page 402
Key Readings......Page 404
References......Page 405
Introduction......Page 412
Expiratory Views......Page 414
Noise......Page 415
Storage Phosphor Systems......Page 416
Clinical Efficacy......Page 417
Decubitus Views......Page 419
Lordotic Views......Page 420
Spiral and Multislice  Computed Tomography......Page 421
Aortography and Bronchial Angiography......Page 422
Ultrasonography......Page 423
Computed Tomography Scan Protocols......Page 424
Contrast Enhancement......Page 426
Medical Imaging and Radiation......Page 427
Low-Level Radiation-Induced Malignancy: Evidence for and Against......Page 430
Techniques......Page 429
Evaluation of Intensive Care  Unit Patients......Page 432
Exacerbation of Chronic Obstructive  Pulmonary Disease......Page 433
Solitary Pulmonary Nodules......Page 434
Multiple Pulmonary Nodules......Page 435
Computed Tomography......Page 436
Magnetic Resonance Imaging......Page 437
Lung Cancer Screening......Page 438
Hilar and Mediastinal Masses......Page 440
Diffuse Lung Disease......Page 441
Nodules.......Page 442
Consolidation and Ground-Glass Opacity.......Page 443
Emphysema.......Page 444
Sensitivity and Specificity.......Page 445
Guiding Lung Biopsy.......Page 446
Bronchiectasis......Page 447
Pulmonary Thromboembolism......Page 448
Congenital Anomalies of the Thoracic  Great Vessels......Page 452
Pleural versus Parenchymal Disease......Page 451
Early Detection......Page 454
efigure Image Gallery......Page 456
Key Readings......Page 455
References......Page 477
Indications and Contraindications......Page 484
Patient-Lesion Selection and Preprocedure Clinical and  Imaging Evaluation......Page 485
Procedure......Page 486
Postprocedure Patient Management......Page 488
Results......Page 489
Parapneumonic Effusions?Empyema......Page 490
Malignant Pleural Effusions......Page 492
Lung Abscess......Page 493
Indications and Contraindications......Page 494
Indications and Contraindications......Page 495
Indications and Contraindications......Page 496
Indications and Contraindications......Page 498
eFigure Image Gallery......Page 500
Key Readings......Page 499
References......Page 504
Ultrasonographic Modes......Page 506
Doppler Ultrasonography......Page 507
Image Acquisition......Page 508
Normal Lungs......Page 509
Alveolar Interstitial Pattern......Page 511
Other Diagnoses......Page 512
Algorithmic Evaluation of  Acute Dyspnea......Page 513
Pleural Effusions......Page 514
Thoracic Procedure Guidance......Page 515
Training......Page 516
Key Readings......Page 517
References......Page 518
Interpretation of PET Images......Page 520
TNM Staging......Page 521
The M Factor......Page 522
Influence on Treatment Choices and Planning with Curative Intent......Page 523
Mesothelioma......Page 526
Neuroendocrine Tumors......Page 527
Response to Therapy......Page 528
New Tracers......Page 531
Key Readings......Page 532
References......Page 533
Sedation and Anesthesia......Page 537
Local Anesthesia......Page 538
Bronchoalveolar Lavage......Page 539
Transbronchial Biopsy......Page 541
Transbronchial Needle Aspiration......Page 542
Endobronchial Ultrasonography......Page 543
Advanced Diagnostic Bronchoscopy......Page 544
Autofluorescence Bronchoscopy......Page 545
Narrow-Band Imaging......Page 546
Key Readings......Page 547
References......Page 548
Therapeutic Bronchoscopy......Page 553
Contraindications, Procedure, Results,  and Complications......Page 554
Results and Complications......Page 555
Indications......Page 556
Stent Placement......Page 557
Microdébrider......Page 558
Brachytherapy......Page 559
Endobronchial Valves......Page 560
Results and Complications......Page 561
Key Readings......Page 562
References......Page 563
Historical Development......Page 565
Equipment......Page 566
Indications......Page 567
Complications......Page 568
Anesthesia......Page 569
Thoracoscopic Technique......Page 570
Pleural Effusions......Page 571
Diagnosis.......Page 572
Therapy.......Page 573
Tuberculous Pleural Effusions Video 24-8.......Page 574
Spontaneous Pneumothorax......Page 575
Diffuse Pulmonary Diseases......Page 576
Differences between Thoracoscopy and Video-Assisted Thoracic Surgery......Page 577
Key Readings......Page 578
References......Page 579
Forced Spirometry......Page 582
indications.......Page 583
forced expiratory volume over time as a percentage of forced vital capacity.......Page 585
general principles.......Page 586
Maximal Voluntary Ventilation.......Page 587
obstructive ventilatory defects.......Page 588
Gas Dilution Methods.......Page 589
gas density.......Page 590
Radiographic Methods.......Page 592
pressure closed-type plethysmograph.......Page 591
pressure-volume plethysmograph.......Page 594
thoracic gas volume.......Page 593
general principles.......Page 595
General Principles.......Page 597
Impulse Oscillometry and Forced Oscillation Methods to Measure Respiratory Resistance Rather Than Airway Resistance.......Page 598
emphysema.......Page 600
Changes in Function over Time.......Page 599
Statistical Considerations.......Page 601
Obstructive Ventilatory Defect.......Page 602
Normal Values.......Page 604
Clinical Applications......Page 603
Other Tests......Page 605
Carbon Monoxide Methods for Clinical Measurement of Pulmonary Diffusing Capacity.......Page 606
Indications......Page 607
protocol.......Page 608
Pulmonary Vascular Obstruction......Page 610
body position.......Page 611
alveolar oxygen pressure.......Page 612
Restrictive Ventilatory Defects......Page 613
Hypoxic Responses......Page 614
Inspiratory Occlusion Pressure......Page 615
Screening Studies......Page 617
“Physiologic? Dead Space also called  Wasted Ventilation......Page 619
Calculation of Quantity of  Venous-to-Arterial Shunt......Page 620
Distribution of Ventilation-Perfusion Ratios......Page 621
Carbon Dioxide.......Page 622
oxygen content.......Page 623
oximetry.......Page 625
transcutaneous carbon dioxide electrode.......Page 626
New Technologies......Page 627
Reversibility.......Page 628
Reversibility.......Page 630
Tests of Nonspecific Airway Responsiveness.......Page 629
Bullous Lung Disease.......Page 631
Emphysema: Lung Volume Reduction Surgery......Page 633
Pulmonary Vascular Obstruction......Page 634
“Poor Cooperation? Pattern......Page 635
Aging Lung......Page 637
decreased muscular efficiency.......Page 639
fluoroscopy.......Page 640
Airline Travel......Page 641
Key Readings......Page 643
eFigure Image Gallery......Page 645
References......Page 655
Oxygen Consumption.......Page 662
Ventilatory Thresholds.......Page 663
Arterial and End-Tidal Partial Pressures of Carbon Dioxide.......Page 664
Individuals with Underlying Cardiopulmonary Disease......Page 665
Heart Failure......Page 666
Pulmonary Vascular Disease for discussion of clinical aspects of pulmonary vascular disease, see Chapter 58......Page 667
Interstitial Lung Diseases for discussion of clinical aspects of interstitial lung diseases, see Chapters 63?66......Page 669
Chronic Obstructive Pulmonary Disease  for clinical discussion, see Chapters 43 and 44......Page 670
Evaluating Dyspnea.......Page 671
Evaluating Combined Cardiovascular and Pulmonary Disorders.......Page 673
Risk Assessment for Extrathoracic Surgery.......Page 674
Heart Failure.......Page 675
Exercise Prescriptions for Cardiac and Pulmonary Rehabilitation Programs for discussion of clinical aspects of rehabilitation, see Chapter 105......Page 676
Cycle Ergometer versus Treadmill.......Page 677
Identifying the Ventilatory Threshold......Page 678
Identifying the Primary System Limiting  Exercise: Algorithmic versus Pattern  Recognition Approaches......Page 680
Exercise Treadmill Testing......Page 682
Key Readings......Page 683
References......Page 684
Mortality and Morbidity in Thoracic Surgery: Can We Identify Patients at the Highest Risk for Adverse Outcomes?......Page 690
Assessment of Cardiac Risk in Patients with Lung Disease......Page 691
Indications for Coronary Revascularization......Page 692
Atrial Fibrillation Prophylaxis......Page 693
Chronic Obstructive Pulmonary Disease......Page 694
Guidelines for Lung Resection......Page 695
Recent Guidelines for Preoperative Testing in Lung Cancer Patients......Page 696
Pain Management......Page 698
Key Readings......Page 700
References......Page 701
Definitions......Page 704
Clinical Approach to Impairment Evaluations......Page 706
History......Page 707
American Thoracic Society Guidelines for Evaluation of Impairment  or Disability......Page 708
Asthma for details concerning diagnosis and management of asthma, see Chapter 42......Page 709
Lung Cancer for discussion of clinical aspects of lung cancer, see Chapter 53......Page 710
Pulmonary Function Testing  for further discussion, see Chapter 25......Page 711
Cardiopulmonary Exercise Testing  see Chapter 26 for details......Page 712
Addressing Discrepancies between Objective and Subjective Data......Page 713
Federal Black Lung Program......Page 715
Work Restrictions......Page 714
Social Security Disability......Page 716
Energy Employees Occupational Illness Compensation Program......Page 717
International Classification of Functioning, Disability, and Health......Page 720
Disease-Specific Impairment......Page 721
Key Readings......Page 722
References......Page 723
Introduction......Page 725
Emotional Phrases?the Affective Dimension of Dyspnea......Page 726
Mechanisms of Dyspnea......Page 727
Assessment of Dyspnea......Page 728
Psychometric Measurement of Dyspnea......Page 729
Overview: Physiologic Categories  of Dyspnea......Page 730
History......Page 731
Special Studies Including Pulmonary Function Tests......Page 732
Reducing Respiratory Effort and Improving Respiratory Muscle Function......Page 733
Decreasing Respiratory Drive......Page 734
Role of Exercise Training in Relieving Dyspnea see Chapter 105......Page 735
Key Readings......Page 736
References......Page 737
Definition of Cough......Page 741
Physiology......Page 742
Larynx and Pharynx......Page 743
Tracheobronchial Tree......Page 744
Central Nervous System Control......Page 745
Mechanics of Coughing......Page 746
Approach to the Patient with Cough......Page 747
Measurement of Cough Frequency  and Intensity......Page 749
Acute Cough......Page 750
Asthma and Associated Eosinophilic Conditions......Page 751
Gastroesophageal Reflux Disease......Page 752
Angiotensin-Converting Enzyme Inhibitor Cough......Page 753
Cough Hypersensitivity Syndrome......Page 754
Narcotic and Non-Narcotic Antitussives......Page 755
Potential New Antitussives......Page 757
eFigure Image Gallery......Page 759
Key Readings......Page 758
References......Page 760
Somatic Pain......Page 764
Hyperalgesia......Page 765
Pleuropulmonary Disorders......Page 766
Pulmonary Hypertension......Page 767
Inflammation or Trauma of the Chest Wall see Chapter 98......Page 768
Pericarditis......Page 769
Gastrointestinal Disorders......Page 770
Cardiac Ischemia......Page 771
Pulmonary Arterial Hypertension  see Chapter 58......Page 773
Pancreatitis......Page 774
Key Readings......Page 775
References......Page 776
Transmission......Page 779
Common Cold......Page 780
Pharyngitis......Page 781
Croup......Page 782
Bronchiolitis......Page 783
Immunocompromised Host......Page 784
Adenovirus Respiratory Disease.......Page 785
Diagnosis......Page 786
Pathogenesis......Page 788
Epidemiology and Transmission......Page 789
Clinical Illness......Page 790
Epidemiology and Transmission......Page 791
Treatment and Prevention......Page 792
Pneumonia.......Page 793
Influenza Virus......Page 794
Clinical Illness......Page 795
Diagnosis......Page 797
Antivirals.......Page 798
Measles Virus......Page 799
Typical Measles.......Page 800
Clinical Features......Page 801
Pathogenesis......Page 802
Epidemiology and Transmission......Page 803
Clinical Illness......Page 804
Rhinovirus......Page 805
Clinical Illness......Page 806
Varicella.......Page 807
Treatment and Prevention......Page 808
eFigure Image Gallery......Page 810
Key Readings......Page 809
References......Page 818
Pathophysiology  and Pathogenesis......Page 825
Age-Related Factors......Page 827
Health Care?Associated Pneumonia......Page 828
Clinical Evaluation......Page 829
Sputum Examination......Page 830
Blood and Pleural Fluid Cultures......Page 831
Bronchoscopic Samples......Page 832
Selection of Antimicrobial Agents......Page 833
Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia......Page 835
Other Pneumonia Syndromes......Page 838
Clinical Course......Page 839
Treatment......Page 840
Microbiologic Diagnosis......Page 841
Treatment......Page 842
Microbiologic Diagnosis......Page 843
Microbiologic Diagnosis......Page 844
Microbiologic Diagnosis.......Page 845
Microbiologic Diagnosis.......Page 846
Clinical Manifestations......Page 847
Clinical Course......Page 848
Clinical Manifestations......Page 849
Nonresponding Pneumonia/Treatment Failure......Page 850
Chlamydophila psittaci Formerly Chlamydia psittaci?Psittacosis......Page 851
Melioidosis Burkholderia pseudomallei......Page 852
Tularemia Francisella tularensis  see Chapter 40......Page 853
Pasteurella multocida......Page 854
Imaging Studies......Page 856
Lung Abscess......Page 858
Smoking Cessation......Page 859
eFigure Image Gallery......Page 862
Key Readings......Page 861
References......Page 878
Pathogenesis......Page 884
Etiologic Agents......Page 885
The Clinical Diagnostic Strategy......Page 886
The Invasive Diagnostic Strategy......Page 887
Summary of the Evidence......Page 888
Initial Treatment......Page 889
Avoiding the Overuse of Antibiotics......Page 890
Specific Prophylaxis Against  Ventilator-Associated Pneumonia......Page 891
Implementing a Structured  Prevention Policy......Page 892
Key Readings......Page 893
References......Page 894
Characteristics of the Mycobacterium Tuberculosis Complex Organisms......Page 899
Transmission of Mycobacterium Tuberculosis......Page 902
Source Case......Page 903
Circumstances of Exposure......Page 904
Pathogenesis......Page 905
Induction of Type I Interferons......Page 906
Latency/Dormancy and Reactivation......Page 907
Innate Immune Cells in Tuberculosis......Page 908
CD8+ T Cells......Page 909
Exogenous Versus Endogenous Infection......Page 910
Risk Factors for Disease......Page 911
Tuberculin Skin Test......Page 912
Interferon-γ Release Assays......Page 913
Patient History......Page 914
Physical Examination......Page 915
Radiographic Features......Page 916
Bacteriologic Evaluation......Page 917
Acid-Fast Staining......Page 918
molecular-based identification methods.......Page 919
Drug Susceptibility Testing......Page 920
Pleural Tuberculosis  see Chapter 80......Page 921
Disseminated Tuberculosis......Page 922
Current Standard Regimens......Page 923
HIV Infection......Page 925
Drug Resistance......Page 927
Associated Conditions.......Page 930
Extrapulmonary Tuberculosis......Page 931
Treatment of Latent Tuberculous Infection......Page 932
Bone and Joint Tuberculosis......Page 934
Central Nervous System Tuberculosis......Page 935
Pericardial Tuberculosis......Page 936
Persons with Stable Radiographic Findings Consistent with Previous Tuberculosis......Page 933
Immunization with Bacille Calmette-Guérin......Page 938
Tackling Current Problems......Page 939
eFigure Image Gallery......Page 941
Key Readings......Page 940
References......Page 942
Beginnings......Page 952
First-Line Drugs......Page 953
Second-Line Drugs......Page 957
Programmatic Considerations......Page 958
References for Appendix......Page 959
Microbiology and Taxonomy......Page 961
Incidence and Prevalence......Page 962
Geographic Distribution and Variation......Page 963
Factors Associated with Infection......Page 964
Factors Associated with Disease......Page 965
Diagnosis and Management of Specific Pathogens......Page 966
Mycobacterium avium Complex......Page 968
Therapy of MAC Lung Disease.......Page 969
Therapy of Mycobacterium kansasii Pulmonary Disease.......Page 971
Mycobacterium malmoense......Page 972
Therapy of Mycobacterium abscessus Pulmonary Disease.......Page 973
Mycobacterium chelonae......Page 974
Hypersensitivity Pneumonitis-Like Nontuberculous Mycobacteria Pulmonary Disease......Page 975
Health Care?Associated Nontuberculous Mycobacteria Disease  and Prevention of  NTM Infections......Page 976
eFigure Image Gallery......Page 978
Key Readings......Page 977
References......Page 979
History and Epidemiology......Page 984
Pathogenesis......Page 985
Disseminated Histoplasmosis......Page 986
Transmissibility......Page 987
Diagnosis......Page 988
Management of Complications......Page 989
Pathogenesis......Page 990
Pulmonary Coccidioidomycosis Valley Fever or Primary Coccidioidal Infection......Page 991
Diagnosis......Page 992
History and Epidemiology......Page 993
Acute Pulmonary Blastomycosis......Page 994
Treatment......Page 995
Pathogenesis......Page 996
Sporotrichosis......Page 997
Key Readings......Page 998
eFigure Image Gallery......Page 999
References......Page 1007
Polyenes......Page 1010
Pathogenesis......Page 1016
Diagnosis......Page 1017
Candidiasis......Page 1018
Pathogenesis......Page 1019
Epidemiology and Definitions.......Page 1020
Epidemiology and Pathogenesis.......Page 1021
Clinical Presentation and Diagnosis.......Page 1022
Treatment.......Page 1023
Clinical Manifestations, Diagnosis and Treatment.......Page 1024
Epidemiology......Page 1025
Diagnosis......Page 1026
Epidemiology and Pathogenesis......Page 1027
Treatment......Page 1028
Dematiaceous Melanized Fungi......Page 1029
eFigure Image Gallery......Page 1031
Key References......Page 1030
References......Page 1040
Evaluation of a Patient with Possible Parasitic Infection of the Lung......Page 1047
Ascariasis......Page 1049
Strongyloidiasis......Page 1050
Diagnosis.......Page 1051
Diagnosis.......Page 1052
Dirofilariasis......Page 1053
Diagnosis.......Page 1054
Clinical Features.......Page 1055
Clinical Features.......Page 1056
Treatment.......Page 1057
Treatment.......Page 1058
Clinical Features.......Page 1059
Diagnosis.......Page 1060
Free-Living Ameba......Page 1061
Trypanosomiasis......Page 1062
eFigure Image Gallery......Page 1064
Key Readings......Page 1063
References......Page 1068
Basics of Bioterrorism......Page 1072
General......Page 1074
Treatment, Prophylaxis, and Prognosis......Page 1075
Clinical Presentation......Page 1076
Clinical Presentation......Page 1077
Clinical Presentation......Page 1078
Diagnosis......Page 1079
Diagnosis......Page 1080
Psittacosis Chlamydophila psittaci......Page 1081
Food Safety Threats e.g., Salmonella Species, Escherichia coli O157:H7, Shigella......Page 1082
Recognition and Response to a Bioterrorism Event......Page 1083
Public Health and Critical Care Response......Page 1084
Key Readings......Page 1085
References......Page 1086
Epidemiology......Page 1088
Prevalence......Page 1089
Mortality......Page 1090
Respiratory Viral Infections......Page 1091
Childhood......Page 1092
Asthma in the Elderly......Page 1093
Initiation of Allergic Lower Airway Responses and Asthma......Page 1094
IL-33/ST2 Axis in Asthma......Page 1095
IgE-Mediated Hypersensitivity......Page 1096
Activation of Airway Epithelial Cells......Page 1097
Products of Arachidonic Acid Metabolism?Leukotrienes, Prostaglandins, and Lipoxins......Page 1098
IL-17 in Asthma......Page 1099
Pathologic Changes in Airway Mucus in Asthma......Page 1100
Airway Pathology in Fatal Cases of Asthma......Page 1101
Clinical Phenotypes......Page 1102
Cellular Biomarkers......Page 1103
Non-Th2 Asthma Phenotypes......Page 1104
Key Readings......Page 1105
References......Page 1106
Definition......Page 1113
Work History......Page 1114
Spirometry......Page 1115
Lung Volumes and Diffusing Capacity......Page 1116
Imaging......Page 1117
Lung Function......Page 1118
Biomarkers......Page 1121
Overview......Page 1122
β2-agonists.......Page 1123
Inhaled Corticosteroids.......Page 1124
Targeted Biologic Agents.......Page 1126
Nonpharmacologic Treatment......Page 1127
Medication Adjustment Based on Asthma Control......Page 1128
Vocal Cord Dysfunction.......Page 1129
Management of Acute Asthma......Page 1130
Clinician-Patient Partnership......Page 1131
eFigure Image Gallery......Page 1133
Key Readings......Page 1132
References......Page 1134
Chronic Bronchitis......Page 1140
Small-Airway Disease......Page 1141
Inflammation in the Lungs of Smokers Without COPD......Page 1142
Cellular Inflammatory Responses......Page 1143
Inflammation, Airway Remodeling,  and Airflow Limitation......Page 1146
Proteases/Antiproteases......Page 1148
Oxidants/Antioxidants in COPD......Page 1149
Role of Aging in the Pathogenesis  of Emphysema......Page 1151
Natural History......Page 1152
Other Environmental Factors......Page 1153
Severity, Activity, and Impact of COPD......Page 1154
COPD Phenotypes......Page 1155
GOLD Combined Assessment Proposal......Page 1156
Key Readings......Page 1157
References......Page 1158
Symptoms......Page 1165
Physical Examination......Page 1166
Lung Volumes......Page 1168
Arterial Blood Gases......Page 1169
Pneumothorax......Page 1170
Cor Pulmonale......Page 1171
Depression and Anxiety......Page 1172
Lymphangioleiomyomatosis......Page 1173
Treatment......Page 1174
Prevention of Respiratory Infections.......Page 1175
Bronchodilators......Page 1176
β-Adrenergic Agonists......Page 1177
Phosphodiesterase-4 Inhibitors......Page 1178
Stepwise Pharmacologic Management......Page 1179
Oxygen During Exercise.......Page 1180
Surgical Treatment of Emphysema......Page 1181
Development of New Treatments......Page 1182
Key Readings......Page 1183
References......Page 1184
Introduction......Page 1191
Evidence That Asthma Is Heritable......Page 1192
The First Genome-Wide Screens for Susceptibility Loci: Family-Based Studies......Page 1193
Candidate Gene Association Studies in Asthma......Page 1195
GWAS Identifies ORMDL3 as a Susceptibility Locus......Page 1196
Admixture Mapping as an Alternative Approach in Admixed Populations......Page 1198
GWAS and Association Studies of Severe Asthma......Page 1200
Rationale for Pharmacogenetic Research in Asthma......Page 1201
Cysteinyl Leukotriene Pharmacogenetics......Page 1202
β2-Adrenergic Receptor Pharmacogenetics......Page 1204
Limitation of Current Pharmacogenetic Associations and Future Directions......Page 1205
Family-Based Linkage Studies for Lung Function Impairment and COPD......Page 1206
Genome-Wide Association Studies of Lung Function in the General Population......Page 1207
Two Large General Population Consortia Identify Seven Loci for  Lung Function......Page 1210
GWAS for Emphysema,  a COPD-Related Phenotype......Page 1211
β2-Adrenergic Receptor Pharmacogenetics......Page 1212
Rare Variants in Asthma and COPD......Page 1213
Genetics of Asthma and Copd: Lessons Learned after 20 Years of Experience......Page 1214
Key Readings......Page 1215
References......Page 1217
Smoking-Related Diseases......Page 1225
Chronic Pulmonary Disease......Page 1226
Infection......Page 1227
Cardiovascular Disease......Page 1228
Other Complications of  Cigarette Smoking......Page 1229
Health Hazards of Secondhand Smoke......Page 1230
Neurobiologic Mechanisms of Addiction......Page 1231
Guidelines......Page 1232
Smoking Cessation Counseling......Page 1233
Nicotine Replacement Therapy......Page 1234
Bupropion......Page 1235
Motivating Smokers to Quit......Page 1236
Electronic Cigarettes......Page 1237
Key Readings......Page 1239
References......Page 1240
Historical Perspective......Page 1243
Genetic Basis......Page 1244
Structure/Activity and  CFTR Gating Mechanism......Page 1245
Cellular Defects Attributable to F508del CFTR......Page 1246
Regulation of Airway Surface  Liquid Homeostasis......Page 1248
Cystic Fibrosis Exocrine  Glandular Epithelium......Page 1249
Mucus Biogenesis, Adhesion,  and Transport......Page 1250
Host Defense and Infection......Page 1251
Diagnostic Algorithms......Page 1252
Lower Respiratory Tract Disease......Page 1254
Microbiology......Page 1256
Imaging......Page 1257
Lung Function......Page 1258
Complications of Respiratory  Tract Disease......Page 1259
Pancreatic Disease......Page 1260
Overview......Page 1261
Monitoring and Aggressive Approach......Page 1262
CFTR Potentiators.......Page 1263
CFTR Correctors.......Page 1265
Translational Readthrough.......Page 1266
Insights on Disease Mechanism Revealed by  CFTR Modulators......Page 1267
Inhaled Antibiotics......Page 1268
Anti-inflammatory Therapy......Page 1269
Treatment of Lung Complications......Page 1270
Surgical Therapy......Page 1271
Lung Transplantation......Page 1272
eFigure Image Galley......Page 1274
Key Readings......Page 1273
References......Page 1281
Classification......Page 1291
Epidemiology......Page 1292
“Vicious Circle? and Microbiology......Page 1293
Cystic Fibrosis......Page 1296
Disorders of Immunity......Page 1297
Ciliated Epithelium Abnormalities......Page 1298
Bronchial Cartilage or Elastic  Fiber Defects......Page 1301
Connective Tissue Abnormalities......Page 1302
Congenital and Developmental Anomalies......Page 1303
Aspiration/Inhalation Accidents......Page 1304
Allergic Bronchopulmonary Aspergillosis......Page 1305
Idiopathic Bronchiectasis......Page 1306
Diagnosis......Page 1307
NSAIDs......Page 1309
Inhaled Corticosteroids......Page 1312
Miscellaneous......Page 1313
eFigure Image Gallery......Page 1315
Key Readings......Page 1314
References......Page 1319
Anatomy, Histology, and Physiology......Page 1324
Diagnosis.......Page 1326
Immunotherapy.......Page 1327
Anatomy, Histology, and Physiology......Page 1328
Paranasal Sinus Disease......Page 1329
Epidemiology......Page 1330
Association with Allergy and Asthma......Page 1331
Chronic Rhinosinusitis with  Nasal Polyposis......Page 1332
Oropharynx......Page 1333
Bone and Cartilage.......Page 1334
Mucosal and Fibromuscular Structures.......Page 1335
Symptoms of Disorders of Swallowing......Page 1336
Evaluation of GERD and Laryngopharyngeal Reflux Disease......Page 1337
Etiology......Page 1338
Unilateral......Page 1339
Glottic Stenosis......Page 1340
Pathophysiology......Page 1341
Treatment......Page 1342
eFigure Image Gallery......Page 1344
Key Readings......Page 1343
References......Page 1345
Anatomic and Physiologic Features......Page 1349
Infectious Bronchiolitis......Page 1350
Bronchiolitis From Inhaled or Ingested Toxins......Page 1351
Respiratory Bronchiolitis......Page 1352
Defining Bronchiolitis Obliterans......Page 1353
Bronchiolitis Obliterans after  Lung Transplantation......Page 1355
Bronchiolitis Obliterans after Allogeneic Stem Cell Transplantation......Page 1357
Treatment of Bronchiolitis Obliterans......Page 1358
Mediastinal Fibrosis see Chapter 54 and 84......Page 1360
Tracheomalacia and Bronchomalacia......Page 1361
Diagnosis of Localized Disorders......Page 1362
Key Readings......Page 1363
References......Page 1364
Introduction......Page 1369
Genetic Susceptibility and  Familial Predisposition......Page 1370
Genomic Instability......Page 1371
Mucosal Response to Injury, the Emergence of Critical Mutations......Page 1372
Role of Viruses in Lung Tumorigenesis......Page 1374
Chromosomal Changes......Page 1375
DNA Adducts......Page 1376
Proteomic Alterations......Page 1377
Molecular Networks?System Biology......Page 1379
Personalized Medicine and  Molecular Therapeutics......Page 1380
Mechanisms of Resistance......Page 1382
Key Readings......Page 1383
References......Page 1384
Race and Ethnicity......Page 1390
Geographic Patterns......Page 1391
LUNG Cancer by Histologic Type......Page 1392
Overview......Page 1394
The Changing Cigarette and  Expanding Marketplace......Page 1395
Diet......Page 1396
Radiation......Page 1397
Indoor Air Pollution......Page 1398
Research Findings on the Genetic Basis of LUNG Cancer Chapter 51......Page 1399
Presence of Human  Immunodeficiency Virus......Page 1400
Gender......Page 1401
Key Readings......Page 1402
References......Page 1403
Screening for Lung Cancer......Page 1408
Lung Cancer Staging......Page 1410
Chest Computed Tomography......Page 1412
Positron Emission Tomography......Page 1413
Search for Metastatic Disease......Page 1414
Invasive Diagnostic and Staging Techniques......Page 1415
Navigational Bronchoscopy......Page 1416
Endobronchial Ultrasound......Page 1417
Mediastinoscopy......Page 1418
Prognostic Factors for Lung Cancer......Page 1419
Stage I......Page 1420
Stage II......Page 1421
Stage IIIA......Page 1422
Targeted Therapy......Page 1423
Small Cell Lung Cancer......Page 1424
Superior Sulcus Tumors and  Pancoast Syndrome......Page 1425
Superior Vena Cava Syndrome......Page 1426
Musculoskeletal Effects......Page 1427
Hypercalcemia......Page 1428
Ectopic Corticotropin Syndrome......Page 1430
Neurologic Effects......Page 1431
eFigure Image Gallery......Page 1433
Key Readings......Page 1432
References......Page 1448
Characterization of Rare Lung Tumors......Page 1455
Mucosa-Associated Lymphoid  Tissue Lymphoma......Page 1456
Other Lymphomas and Lymphoproliferative Diseases......Page 1458
Carcinoid Tumors......Page 1459
Mucoepidermoid Carcinoma......Page 1460
Sarcomatoid Carcinomas Other  Than Pneumoblastoma......Page 1461
Vascular Sarcomas......Page 1462
Inflammatory Myofibroblastic Tumor......Page 1464
Other Pseudotumors......Page 1466
Respiratory Tract Papillomatosis......Page 1467
Amyloidosis......Page 1468
General Issues......Page 1469
Key Readings......Page 1470
eFigure Image Gallery......Page 1471
References......Page 1496
Clinical History......Page 1500
Mechanism of Metastasis to the Lung......Page 1501
Differential Diagnosis......Page 1502
Pathology......Page 1503
Options for Obtaining a Tissue Diagnosis......Page 1504
Palliative Care......Page 1505
Surgical Resection of Metastases......Page 1506
Vascular Embolic Metastasis......Page 1508
Key Readings......Page 1509
eFigure Image Gallery......Page 1510
References......Page 1513
Solitary Papillomas......Page 1515
Adenomas......Page 1516
Micronodular Pneumocyte Hyperplasia......Page 1518
Sclerosing Hemangioma......Page 1519
Hamartoma and Related Lesions......Page 1520
Inflammatory Myofibroblastic Tumor......Page 1521
Solitary Fibrous Tumor......Page 1522
Meningothelial-Like Nodules and Intrapulmonary Meningioma......Page 1523
Key Readings......Page 1524
eFigure Image Gallery......Page 1525
References......Page 1534
Introduction......Page 1538
Pathogenesis and  Risk Factors......Page 1540
Natural History: Deep Venous Thrombosis......Page 1541
Natural History:  Pulmonary Embolism......Page 1542
Clinical Presentation......Page 1543
Contrast Venography......Page 1544
Duplex Ultrasonography......Page 1545
Clinical Prediction Rules......Page 1546
Standard Laboratory Evaluation......Page 1547
Ventilation-Perfusion Scanning......Page 1548
Computed Tomography  Pulmonary Angiography......Page 1549
Lower Extremity Venous Evaluation......Page 1551
Clinical Prediction Rules......Page 1552
Low-Dose Unfractionated Heparin......Page 1554
Direct Inhibitors of Factor Xa and  of Thrombin......Page 1555
Unfractionated Heparin and Low-Molecular-Weight Heparin......Page 1556
Direct Inhibitors of Factor Xa and  of Thrombin......Page 1557
Stratification According to the Risk of Massive Pulmonary Embolism......Page 1558
Pulmonary Embolectomy......Page 1559
Postembolic Prophylaxis......Page 1560
Chronic Thromboembolic Pulmonary Hypertension......Page 1561
Diagnosis......Page 1562
Treatment......Page 1564
Fat Embolism......Page 1568
Other Emboli......Page 1569
eFigure Image Gallery......Page 1570
Key Readings......Page 1567
References......Page 1579
Pathology......Page 1589
Pulmonary Arterial Hypertension Associated with Other Conditions......Page 1591
Diagnosis......Page 1594
Echocardiogram......Page 1596
Treatment and Prognosis......Page 1597
Warfarin.......Page 1598
Calcium Channel Antagonists......Page 1599
Subcutaneous and Intravenous Treprostinil Sodium Remodulin.......Page 1600
Prostacyclin Dosing......Page 1601
Inhaled Iloprost Ventavis and Treprostinil Tyvaso.......Page 1602
Endothelin-1 Antagonist Therapy......Page 1603
Combination Therapy......Page 1604
Survival......Page 1605
Key Readings......Page 1606
eFigure Image Gallery......Page 1607
References......Page 1611
Prevalence......Page 1615
Chronic Obstructive Pulmonary Disease......Page 1616
Pathologic Changes  and Pathogenesis......Page 1618
Pulmonary Vascular Remodeling......Page 1619
Neurohormones......Page 1620
Right Ventricle......Page 1621
Symptoms and Signs......Page 1623
Chest Radiography......Page 1624
Echocardiography......Page 1625
Right Heart Catheterization......Page 1626
Lifestyle Modifications......Page 1627
Anticoagulation......Page 1628
Treatment of Decompensated RV Failure......Page 1629
Prostacyclin and Its Analogues.......Page 1630
Riociguat.......Page 1631
Key Readings......Page 1632
References......Page 1633
Classification......Page 1638
Normal Vascular Anatomy and Histology......Page 1639
Pathogenesis and Etiology......Page 1640
Diffuse Alveolar Hemorrhage see Chapter 67......Page 1641
Mononeuritis Multiplex......Page 1642
Other Laboratory Studies......Page 1643
Granulomatosis with Polyangiitis......Page 1644
Eosinophilic Granulomatosis with Polyangiitis see Chapter 68......Page 1646
General Principles......Page 1647
Active Generalized Disease......Page 1649
Maintenance......Page 1650
Monitoring for Complications......Page 1651
eFigure Image Gallery......Page 1653
References......Page 1658
Key Readings......Page 1652
Hereditary Hemorrhagic Telangiectasia......Page 1662
Clinical Features and Diagnosis.......Page 1663
Anatomic Basis......Page 1664
Exercise.......Page 1665
Strokes and Cerebral Abscess......Page 1666
Imaging......Page 1667
Contrast Echocardiography.......Page 1668
Physiologic Outcome.......Page 1669
Surgery.......Page 1671
Anatomy......Page 1672
Managements of Hemoptysis......Page 1673
Clinical Features......Page 1674
Infection......Page 1675
Diagnosis and Treatment......Page 1676
eFigure Image Gallery......Page 1678
Key Readings......Page 1677
References......Page 1687
Pathophysiology of Pulmonary Edema......Page 1692
Increased Pressure Edema......Page 1693
Pathophysiology......Page 1694
Increased Microvascular Hydrostatic Pressure.......Page 1695
Decreased Perimicrovascular Hydrostatic Pressure.......Page 1696
Increased Permeability Edema......Page 1697
Pathophysiology......Page 1698
Mechanisms......Page 1699
Definitions......Page 1700
Symptoms and Signs......Page 1701
Chest Radiographs......Page 1702
Measurement of Lung Water and Barrier Function......Page 1703
Increased Pressure Edema......Page 1704
Decreasing Venous Return......Page 1705
Vasodilators.......Page 1706
General Principles......Page 1707
Lung-Protective Ventilator Strategies......Page 1708
Neuromuscular Blocking Agents.......Page 1709
Resolution of Pulmonary Edema......Page 1710
Increased Permeability Edema......Page 1711
Overview......Page 1712
Key Readings......Page 1713
References......Page 1714
Introduction......Page 1719
Clinical and Histologic Classification of Interstitial Lung Disease......Page 1720
Occupational and Environmental History......Page 1721
Chest Radiography......Page 1722
Interstitial Pattern.......Page 1723
Linear or Reticular.......Page 1724
Computed Tomography......Page 1725
Ventilatory Function......Page 1727
Flow Resistance......Page 1728
Exercise......Page 1729
Bronchoalveolar Lavage......Page 1730
Surgical Lung Biopsy......Page 1731
Idiopathic Pulmonary Fibrosis......Page 1732
Ability of HRCT Scanning to Diagnose ILD.......Page 1733
Gallium Scanning.......Page 1734
Pulmonary Function Tests......Page 1735
Abnormalities during Sleep......Page 1736
Histopathology......Page 1737
Etiologic Factors and Pathogenic Mechanisms......Page 1738
Diagnosis......Page 1739
Pulmonary Physiologic Tests.......Page 1740
Therapeutic Approach......Page 1741
Pirfenidone.......Page 1742
Treatment of Gastroesophageal Reflux.......Page 1743
Acute Exacerbations of Idiopathic  Pulmonary Fibrosis......Page 1744
Computed Tomography Scan.......Page 1745
Differential Diagnosis......Page 1746
Pulmonary Function Tests......Page 1747
Clinical Course and Outcome......Page 1748
Cryptogenic Organizing Pneumonia......Page 1749
Pathologic Features......Page 1750
Clinical Features......Page 1751
Idiopathic Pleuroparenchymal Fibroelastosis......Page 1752
eFigure Image Gallery......Page 1754
Key Readings......Page 1753
References......Page 1766
Microbial Agents......Page 1773
Exposure Settings and  Risk Factors......Page 1774
Immunopathogenesis......Page 1775
Histopathology......Page 1776
Signs and Symptoms......Page 1777
Imaging......Page 1778
Diagnosing Hypersensitivity Pneumonitis......Page 1779
Exposure History......Page 1780
Lung Biopsy......Page 1781
Treatment......Page 1782
Prevention......Page 1783
eFigure Image Galley......Page 1785
Key Readings......Page 1784
References......Page 1788
Epidemiology and Risk Factors......Page 1791
Chemically Induced Scleroderma- Like Disorders......Page 1792
epithelial damage.......Page 1793
Imaging......Page 1794
Bronchoalveolar Lavage......Page 1795
Prognosis......Page 1796
Treatment......Page 1797
Pulmonary Vascular Disease  in Systemic Sclerosis......Page 1798
Interstitial Pulmonary Fibrosis......Page 1799
Follicular Bronchiolitis......Page 1801
Drug-Induced Pulmonary Disease......Page 1802
Treatment of Pulmonary Complications......Page 1803
Extrapulmonary Restriction......Page 1804
Pleural Disease......Page 1805
Tracheobronchial Disease......Page 1806
Epidemiology and Risk Factors......Page 1807
Laboratory Tests.......Page 1808
Undifferentiated Connective Tissue Disease......Page 1809
Relapsing Polychondritis......Page 1810
Behçet Syndrome......Page 1811
Marfan Syndrome......Page 1812
eFigure Image Galley......Page 1814
Key Readings......Page 1813
References......Page 1821
Potential Antigens......Page 1828
Genetic Aspects......Page 1829
Radiographic Findings......Page 1830
Serum Markers for Disease......Page 1831
Bronchoalveolar Lavage......Page 1833
Extrapulmonary Tissue Biopsy......Page 1834
Clinical Phenotypes Suggestive of Sarcoidosis......Page 1835
Pathologic Findings......Page 1836
Chest Computed Tomography Scanning......Page 1838
Health-Related Quality of Life......Page 1839
Nervous System......Page 1840
Ears, Nose, and Throat......Page 1841
Anti-Inflammatory Medications......Page 1842
Pulmonary Hypertension......Page 1844
Lung Transplantation......Page 1845
Key Readings......Page 1846
References......Page 1847
Radiology and Laboratory Evaluation......Page 1854
Classification Schema......Page 1855
Role of Surgical Lung Biopsy and Renal Biopsy......Page 1856
Therapeutic Approach......Page 1857
Granulomatosis with Polyangiitis Wegener Granulomatosis.......Page 1858
Microscopic Polyangiitis.......Page 1859
Goodpasture Syndrome.......Page 1860
Coagulation Disorders......Page 1862
Mitral Stenosis.......Page 1863
Pulmonary Capillary Hemangiomatosis.......Page 1864
Dyskeratosis Congenita......Page 1865
Pulmonary Alveolar Microlithiasis......Page 1866
eFigure Image Gallery......Page 1868
Key Readings......Page 1867
References......Page 1874
Eosinophil Biology......Page 1879
Clinical Presentation......Page 1880
Diagnosis......Page 1881
Imaging......Page 1883
Treatment and Prognosis......Page 1884
Imaging......Page 1885
History and Nomenclature......Page 1886
Clinical Features......Page 1887
Imaging......Page 1888
Diagnosis......Page 1889
Treatment and Prognosis......Page 1890
Pathogenenesis......Page 1891
Treatment and Prognosis......Page 1892
Pathogenesis.......Page 1893
Eosinophilic Pneumonia  in Larva Migrans Syndrome......Page 1894
Pathogenesis.......Page 1895
Imaging.......Page 1896
Drugs......Page 1897
Organizing Pneumonia......Page 1898
Other Lung Diseases with  Occasional Eosinophilia......Page 1899
eFigure Image Gallery......Page 1901
Key Readings......Page 1900
References......Page 1906
Epidemiology......Page 1914
Tumor Suppressor Proteins Control Cell Growth......Page 1915
Tuberous Sclerosis Complex Mutations Are Found in the Lung and Kidney Lesions of Patients with Sporadic Lymphangioleiomyomatosis......Page 1916
Mechanisms of Matrix Remodeling in Lymphangioleiomyomatosis......Page 1918
Imaging Studies......Page 1919
Pulmonary Function Testing......Page 1922
Pathology......Page 1924
Differential Diagnosis......Page 1925
Trials and Treatment......Page 1926
Sirolimus......Page 1927
Pregnancy......Page 1928
Pleural Disease......Page 1929
Progression and Prognosis......Page 1930
Future Clinical Trials in Lymphangioleiomyomatosis......Page 1931
eFigure Image Gallery......Page 1933
Key Readings......Page 1932
References......Page 1940
Granulocyte/Macrophage  Colony-Stimulating Factor......Page 1945
Role of GM-CSF Autoantibodies in Primary PAP......Page 1946
Genetic Factors......Page 1947
Environmental Factors......Page 1949
Pulmonary Surfactant Metabolic Dysfunction......Page 1950
Epidemiology......Page 1951
Clinical Presentation......Page 1952
Radiographic Appearance......Page 1953
Laboratory Studies......Page 1954
Approach to Diagnosis......Page 1955
Secondary Infections......Page 1956
Whole-Lung Lavage......Page 1957
Clinical Practice Guidelines......Page 1958
Key Readings......Page 1959
eFigure Image Gallery......Page 1960
References......Page 1968
Chemotherapeutic Agents......Page 1972
Bleomycin......Page 1974
Other Antibiotic Chemotherapeutic Agents......Page 1975
Ifosfamide......Page 1976
Cytosine Arabinoside......Page 1977
Nitrosoureas......Page 1978
All-Trans Retinoic Acid......Page 1979
Rituximab.......Page 1980
Interferons.......Page 1981
Chronic Reaction......Page 1982
Heroin......Page 1983
Angiotensin-Converting  Enzyme Inhibitors......Page 1984
Amiodarone......Page 1985
β-Adrenergic Antagonists......Page 1986
Biologic Agents......Page 1987
Drug-Induced Systemic Lupus Erythematosus......Page 1988
Radiographic Contrast  Medium?Induced Leukostasis......Page 1989
Esophageal Variceal Sclerotherapy......Page 1990
Key Readings......Page 1991
eFigure Image Gallery......Page 1992
References......Page 2005
Introduction......Page 2009
Causal Agents......Page 2010
Host-Related Factors......Page 2011
Diagnosis......Page 2012
Outcome and Management of Sensitizer-Induced Asthma......Page 2014
Epidemiologic Aspects......Page 2015
Risk Factors......Page 2016
Prevention......Page 2017
Diagnosis of Work-Exacerbated Asthma......Page 2018
Socioeconomic Impact of Work-Exacerbated Asthma......Page 2019
Key Readings......Page 2020
References......Page 2021
Exposure-Response Relationships......Page 2024
Clinical Issues, Lung Function,  and Principles of Management......Page 2025
Epidemiology and Implications for Clinical Practice......Page 2026
Pathology......Page 2027
Pathogenesis......Page 2028
Clinical Features......Page 2029
Radiographic Features......Page 2030
Definition and Occupations at Risk......Page 2031
Pathology......Page 2032
Pathogenesis......Page 2033
Chest Radiography......Page 2034
History and Uses......Page 2035
Sources of Human Exposure......Page 2036
Pathology and Pathogenesis......Page 2038
Radiographic Features......Page 2039
Diagnosis and Complications......Page 2040
Clinical Features......Page 2041
Benign ASBESTOS-Related  Pleural Effusions......Page 2042
Nonasbestos Mineral Silicates and Lung Disease......Page 2043
Man-Made Vitreous Fibers......Page 2044
Clinical Features......Page 2045
New Pneumoconioses......Page 2046
eFigure Image Gallery......Page 2048
Asbestos......Page 2047
References......Page 2055
Pollutants?What They are and Why They Matter......Page 2060
General Properties, Sources,  and Distribution of Pollutants......Page 2061
Deposition of and Clearance of Particles see Chapter 11......Page 2062
Oxidative Stress......Page 2063
Epidemiologic Studies......Page 2064
Sources of Indoor Pollution......Page 2065
Secondhand Smoke and Obstructive Lung Disease......Page 2066
Other Indoor Pollutants?“Toxic? Indoor Environment......Page 2067
Sulfur Dioxide......Page 2068
Nitrogen Dioxide......Page 2069
Ozone......Page 2070
Key Readings......Page 2071
References......Page 2072
Patterns of Response to  Irritant Inhalation......Page 2077
General Management Principles......Page 2078
Chlorine, Chloramines, Hydrochloric Acid, and Related Chemicals......Page 2079
Overview......Page 2081
Cadmium, Mercury, and Nickel......Page 2082
Metal Fume Fever, Polymer Fume Fever, Organic Dust Toxic Syndrome, and Other Inhalation Fevers......Page 2083
Paraquat......Page 2084
Pharmacologic Syndromes......Page 2085
Miscellaneous Exposures......Page 2086
Useful Resources for Information about Specific Toxins......Page 2087
References......Page 2088
Rib Fractures......Page 2095
Sternal Fractures.......Page 2097
Pulmonary Contusion......Page 2098
Pulmonary Laceration......Page 2099
Pneumothorax.......Page 2100
Hemothorax.......Page 2102
Diaphragm Injuries......Page 2103
Introduction......Page 2104
Inertia Forces......Page 2105
Key Readings......Page 2106
eFigure Image Gallery......Page 2107
References......Page 2113
Acute Response.......Page 2117
Intermittent Hypoxic Exposure.......Page 2118
Diffusion.......Page 2119
Oxygen-Hemoglobin Affinity......Page 2120
Fluid Homeostasis and Renal Function......Page 2121
Ventilation......Page 2122
Training at High Altitude......Page 2123
Natural Course of Untreated AMS.......Page 2124
Prevention.......Page 2125
High-Altitude Cerebral Edema......Page 2127
Possible Mechanisms.......Page 2128
Treatment.......Page 2130
Pathophysiology.......Page 2131
Chronic Obstructive Pulmonary Disease and Interstitial Lung Disease......Page 2132
Altitude-Illness Medications and Underlying Medical Diseases......Page 2133
Key Readings......Page 2134
References......Page 2135
Energy Needs for Diving......Page 2139
Disorders Related to Diving: Nomenclature......Page 2140
Clinical Manifestations of Arterial Gas Embolism.......Page 2141
Less Common Forms of Barotrauma......Page 2142
Factors Affecting Risk for  Decompression Sickness......Page 2143
Clinical Manifestations......Page 2144
Emergency Treatment......Page 2145
Diving-Induced Arrhythmias......Page 2146
Cardiovascular System......Page 2147
Treatment......Page 2148
Key Readings......Page 2149
References......Page 2150
Introduction......Page 2153
Blood Supply......Page 2154
Normal Pleural Liquid and  Protein Turnover......Page 2155
Pleural Effusions......Page 2156
Effects of Pleural Effusions on Lung and Cardiac Function......Page 2157
Separation of Exudates  From Transudates......Page 2158
Differentiating Exudative  Pleural Effusions......Page 2159
Pleural Fluid White Cell Count and Differential......Page 2160
Other Diagnostic Tests for Malignancy......Page 2161
Tests for Collagen Vascular Diseases......Page 2162
Useful Radiographic Tests in Patients with Suspected Pleural Disease......Page 2163
Magnetic Resonance Imaging......Page 2164
Needle Biopsy of the Pleura......Page 2165
Thoracoscopy or Video-Assisted Thoracic Surgery......Page 2166
Clinical Manifestations......Page 2167
Pathophysiology......Page 2168
Nephrotic Syndrome......Page 2169
Other Causes of Transudative  Pleural Effusions......Page 2170
Clinical Manifestations......Page 2171
Esophageal Perforation......Page 2172
Chronic Pancreatic Pleural Effusion.......Page 2173
Liver Transplantation......Page 2174
Clinical Manifestations.......Page 2175
Uremia......Page 2176
Post?Coronary Artery Bypass Surgery......Page 2177
Interleukin-2......Page 2178
Trapped Lung......Page 2179
Yellow Nail Syndrome......Page 2180
Key Readings......Page 2181
eFigure Image Gallery......Page 2182
References......Page 2187
Incidence......Page 2192
Clinical Presentation......Page 2193
Microbiology......Page 2194
Antibiotic Selection  and Duration......Page 2195
Radiology......Page 2196
Bronchoscopy......Page 2197
Fibrinolytic Therapy......Page 2198
Summary......Page 2199
Diagnosis......Page 2200
Aspergillosis......Page 2201
Histoplasmosis......Page 2202
Amebiasis......Page 2203
Paragonimiasis......Page 2204
eFigure Image Gallery......Page 2206
Key Readings......Page 2205
References......Page 2211
Pathophysiology of Pneumothorax......Page 2214
Etiologic Factors......Page 2215
Diagnosis......Page 2216
Simple Aspiration......Page 2217
Thoracoscopy......Page 2218
Diagnosis......Page 2219
Pneumothorax Secondary to Pneumocystis in Patients with AIDS......Page 2220
Treatment......Page 2221
Diagnosis and Treatment......Page 2222
Treatment......Page 2223
Clinical Manifestations......Page 2224
Prevention......Page 2225
Etiology......Page 2226
Diagnosis......Page 2227
General Approaches......Page 2228
Nontraumatic Chylothorax.......Page 2229
Pathogenesis......Page 2230
Diagnosis......Page 2231
Complications......Page 2232
Fibrothorax......Page 2233
Diagnosis......Page 2234
Key Readings......Page 2235
eFigure Image Gallery......Page 2236
References......Page 2241
Malignant Pleural Effusions......Page 2246
Radiographic Evaluation......Page 2248
Diagnosis......Page 2249
Therapy and Palliation......Page 2250
Incidence and Etiology......Page 2252
Genetic Characteristics......Page 2253
Radiographic Evaluation......Page 2254
Diagnosis......Page 2255
Prognosis and Staging......Page 2256
Surgical Therapy......Page 2257
Immunotherapy......Page 2258
Solitary Fibrous Tumor  of the Pleura......Page 2259
Primary Effusion Lymphoma......Page 2260
Pyothorax-Associated Lymphoma......Page 2261
eFigure Image Gallery......Page 2263
Key Readings......Page 2262
References......Page 2269
Normal Anatomy of  the Mediastinum......Page 2274
Systemic Symptoms and Syndromes......Page 2276
Computed Tomography......Page 2277
Ultrasonography......Page 2278
Nuclear Imaging......Page 2279
Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration......Page 2280
Classification......Page 2281
Thymic Neoplasms......Page 2282
Germ Cell Tumors......Page 2284
Parathyroid Lesions......Page 2285
Primary Carcinoma......Page 2286
Neurogenic Tumors......Page 2287
Initial Evaluation......Page 2289
Surgical Management......Page 2290
Key Readings......Page 2291
eFigure Image Gallery......Page 2292
References......Page 2326
Pathophysiology......Page 2330
Mechanism of “Spontaneous? Alveolar Rupture.......Page 2331
Spread of Air following Alveolar Rupture.......Page 2332
Predisposing Conditions.......Page 2333
Barotrauma.......Page 2334
Radiographic Features......Page 2335
Management of Spontaneous Pneumomediastinum......Page 2336
Mediastinitis Resulting from Visceral Perforation......Page 2337
Direct Extension of Infection from Extramediastinal Sites......Page 2339
Mediastinitis After Cardiothoracic Surgery......Page 2340
Etiologies and Pathophysiology......Page 2341
Superior Vena Cava Obstruction.......Page 2342
Diagnosis and Management......Page 2343
Key Readings......Page 2344
eFigure Image Gallery......Page 2345
References......Page 2353
Wakefulness and Sleep......Page 2357
Wakefulness......Page 2358
The “Sleep Switch?......Page 2359
Effects of Common Neurodepressive Drugs on Brain Arousal State......Page 2360
Inspiration......Page 2361
Respiratory Muscles Vary in the Degree of Their Relationship to Breathing......Page 2363
Application......Page 2364
Application......Page 2365
Principle......Page 2366
Application......Page 2367
Principle......Page 2368
Application......Page 2369
Application......Page 2370
Individualized Therapy Targeting Underlying Mechanisms......Page 2371
Key Readings......Page 2372
References......Page 2373
Regulation of Arterial  CO2 Tension......Page 2374
Permissive Hypercapnia......Page 2375
Acid Base and Ionic Balance......Page 2376
Gas Exchange......Page 2377
Diaphragmatic Function......Page 2378
Cerebral Perfusion?Flow Versus Volume......Page 2380
Cerebral Oxygenation......Page 2381
Mediator Production......Page 2382
Mechanism of Phagocyte Inhibition......Page 2383
Lung Permeability and Fluid Clearance......Page 2384
Gene Activation......Page 2385
Neonatal and Pediatric  Respiratory Failure......Page 2386
Neonatal Brain Injury......Page 2387
Myocardial Ischemia......Page 2388
Experimental Sepsis......Page 2389
Approaches to Minimize Hypercapnia......Page 2390
Extracorporeal Technologies......Page 2391
Key Readings......Page 2392
References......Page 2394
Sleep and Immune Function......Page 2402
Metabolic......Page 2403
Systemic Inflammation......Page 2404
Endothelial Dysfunction......Page 2405
Key References......Page 2406
References......Page 2407
Introduction and Definitions......Page 2409
Upper Airway Size......Page 2412
Gravity/Body Position......Page 2413
Gender Differences......Page 2414
Unattended Sleep Studies......Page 2415
Symptoms, Signs......Page 2416
Central Disorders of Hypersomnolence......Page 2417
Other Conditions and Medications......Page 2418
Cognitive Impairment......Page 2419
Pathophysiology......Page 2420
Myocardial Infarction......Page 2421
Mortality......Page 2422
Positive Airway Pressure......Page 2423
Perioperative Considerations in OSA......Page 2424
Key Readings......Page 2425
eFigure Image Galley......Page 2426
References......Page 2428
Classification of Central Sleep Apnea......Page 2435
Developmental and Degenerative Diseases.......Page 2437
Tumors.......Page 2438
Treatment......Page 2439
Central Sleep Apnea in Association with Heart Failure?Cheyne-Stokes Respiration.......Page 2440
Clinical Features......Page 2443
Adaptive Servoventilation.......Page 2444
Central Sleep Apnea Associated with Cerebrovascular Disease.......Page 2445
Central Sleep Apnea Associated with Acromegaly.......Page 2446
Complex Sleep Apnea.......Page 2447
Idiopathic Central Sleep Apnea.......Page 2448
Key Readings......Page 2449
References......Page 2450
Introduction......Page 2455
Immunologic Abnormalities......Page 2456
Fiberoptic Bronchoscopy......Page 2457
Bacteria......Page 2458
Diagnosis.......Page 2459
Mycobacterium tuberculosis......Page 2460
CD4+ Lymphocyte Count.......Page 2461
Diagnosis.......Page 2462
Prevention of Disease.......Page 2463
Prevention of Disease.......Page 2464
Fungi......Page 2465
Clinical Features.......Page 2466
Diagnosis.......Page 2467
Corticosteroid Therapy.......Page 2468
Cryptococcus Species......Page 2469
Diagnosis.......Page 2470
Diagnosis.......Page 2471
Clinical Features.......Page 2472
Clinical Features.......Page 2473
Treatment.......Page 2474
Other Viruses......Page 2475
Other Parasites......Page 2476
Imaging.......Page 2477
Imaging.......Page 2478
Multicentric Castleman Disease......Page 2479
Treatment......Page 2480
Nonspecific Interstitial Pneumonitis......Page 2481
Immune Reconstitution  Inflammatory Syndrome......Page 2482
eFigure Image Gallery......Page 2484
Key Readings......Page 2483
References......Page 2507
Bacterial......Page 2515
Viral......Page 2518
Fungal......Page 2520
Noninfectious Complications......Page 2521
Respiratory Failure......Page 2522
Drug-Induced Pulmonary Toxicity......Page 2525
Obliterative Bronchiolitis and Cryptogenic Organizing Pneumonia......Page 2527
Pulmonary Metastatic Calcifications......Page 2528
Key Readings......Page 2529
eFigure Image Gallery......Page 2530
References......Page 2541
Introduction......Page 2549
Diagnostic Workup......Page 2550
Antibody Deficiencies......Page 2551
Severe Combined Immunodeficiency......Page 2552
X-Linked Agammaglobulinemia......Page 2553
Common Variable Immunodeficiency......Page 2554
X-Linked Hyper-Igm Syndrome......Page 2556
Gata-2 Deficiency......Page 2557
Ataxia-Telangiectasia......Page 2558
Phagocytic Cell Disorders......Page 2559
Chronic Granulomatous Disease......Page 2560
Defects in the IFN-γ/IL-12/IL-23 Axis......Page 2561
Complement Deficiencies......Page 2562
Key Readings......Page 2563
References......Page 2564
Pathogenesis......Page 2568
Inflammatory Bowel Disease......Page 2570
Pathogenesis......Page 2572
Diagnosis......Page 2573
Portopulmonary Hypertension......Page 2574
Primary Biliary Cirrhosis......Page 2575
Respiratory Failure......Page 2576
Pleural Effusion......Page 2577
Pulmonary Edema......Page 2578
Sleep Apnea......Page 2579
Key Readings......Page 2580
References......Page 2582
Polycythemia......Page 2586
Sickle Cell Disease......Page 2587
Pathophysiology.......Page 2588
Clinical Features and Evaluation.......Page 2590
Pulmonary Hypertension......Page 2591
Epidemiology.......Page 2592
Pathogenesis.......Page 2593
Clinical Features and Evaluation.......Page 2594
Treatment.......Page 2596
Thalassemia......Page 2598
Leukemias......Page 2599
Inherited Thrombophilia......Page 2600
Epidemiology......Page 2601
Treatment......Page 2602
eFigure Image Gallery......Page 2604
Key Readings......Page 2603
References......Page 2610
Diabetes Mellitus......Page 2615
Thyroid Disorders......Page 2617
Hyperthyroidism......Page 2618
Hypothyroidism......Page 2619
Parathyroid Diseases......Page 2620
Acromegaly......Page 2621
Key Readings......Page 2622
References......Page 2623
Alterations in Respiratory Physiology......Page 2627
Asthma......Page 2628
Bacterial Pneumonia......Page 2630
Tuberculosis......Page 2631
Pulmonary Embolism......Page 2632
Amniotic Fluid Embolism......Page 2634
Acute Respiratory Distress Syndrome......Page 2635
Catamenial Pneumothorax......Page 2636
Ovarian Hyperstimulation Syndrome......Page 2637
Key Readings......Page 2638
References......Page 2639
Lower Motor Neurons......Page 2642
Respiratory Muscles.......Page 2643
Diseases Affecting the Respiratory System......Page 2644
Spinal Cord Injury.......Page 2645
Acute Immune-Mediated Polyneuropathy.......Page 2646
Myasthenia Gravis.......Page 2647
Duchenne and Becker Muscular Dystrophies.......Page 2648
Chronic Inflammatory Myopathies.......Page 2649
Neuromuscular Disease Related to Critical Illness......Page 2650
Unilateral Diaphragm Paralysis......Page 2651
Bilateral Diaphragm Paralysis......Page 2652
Approach to Respiratory Evaluation and Management of the Individual with Neuromuscular Disease......Page 2653
Ventilatory Support......Page 2654
Nocturnal Ventilatory Support......Page 2655
Cough Support......Page 2656
Key Readings......Page 2657
References......Page 2658
Pulmonary Function and Respiratory Mechanics......Page 2662
Control of Breathing and  Sleep-Disordered Breathing......Page 2664
Medical Treatment......Page 2665
Thoracoplasty......Page 2666
Diagnosis and Etiology......Page 2667
Treatment......Page 2668
Respiratory Mechanics......Page 2669
General Aspects......Page 2670
Pulmonary and Respiratory Muscle Function......Page 2671
Interstitial Lung Disease......Page 2672
Treatment......Page 2673
Pulmonary Function......Page 2674
Respiratory Mechanics......Page 2675
Exercise Capacity......Page 2676
Key Readings......Page 2677
References......Page 2678
Introduction......Page 2682
Acquired Causes......Page 2683
Other Acquired Causes......Page 2684
Cervical Spinal Cord Injury......Page 2685
Myopathies......Page 2686
Ventilator-Induced Diaphragmatic Dysfunction......Page 2687
Assessment of Need for Mechanical Ventilation in Neuromuscular Weakness......Page 2688
Principles of Ventilator Management......Page 2689
Pathophysiology......Page 2690
Medical Therapy......Page 2691
Postoperative Patients......Page 2692
Mask Selection.......Page 2693
Oxygenation and Humidification.......Page 2694
Indications and Patient Selection.......Page 2695
Noninvasive Ventilation.......Page 2696
Acknowledgment......Page 2697
Key Readings......Page 2698
References......Page 2699
Classification of Hypoxemia......Page 2704
Causes of Acute  Respiratory Failure......Page 2705
Diagnosis......Page 2706
Incidence......Page 2707
Pathology......Page 2708
Neutrophils and Other Inflammatory Mediators......Page 2709
Angiopoietins.......Page 2711
Ventilator-Induced Lung Injury......Page 2712
Genetic Determinants......Page 2713
Complications......Page 2714
Hemodynamic Management......Page 2715
Vasodilators.......Page 2716
Antioxidants and Anti-inflammatory Agents Other Than Steroids.......Page 2717
Pressure and Volume Limitation......Page 2718
Neuromuscular Blockade......Page 2719
The Role of PEEP and Recruitment Maneuvers......Page 2720
Mechanical Ventilation of Patients in the Prone Position Proning......Page 2721
Liquid Ventilation......Page 2722
Long-Term Outcomes......Page 2723
eFigure Image Gallery......Page 2725
Key Readings......Page 2724
References......Page 2726
Mode Controller/Feedback Systems......Page 2732
Monitors and Graphic Displays......Page 2734
PEEPi and the Ventilatory Pattern......Page 2735
Alveolar Recruitment and Gas Exchange......Page 2736
Mechanical Loads......Page 2737
Ventilator-Induced Lung Injury......Page 2738
Oxygen Toxicity......Page 2739
Breath Cycling......Page 2740
Mechanical Ventilatory Support Involves Tradeoffs......Page 2741
Parenchymal Lung Injury......Page 2742
Obstructive Airway Disease......Page 2743
Recovering Respiratory Failure?“Weaning? and Discontinuation Process......Page 2744
Positive-Pressure Ventilation in  the Prone Position......Page 2745
Endotracheal Tube Resistance Compensation......Page 2746
Neurally Adjusted Ventilatory Assistance......Page 2747
Key Readings......Page 2748
References......Page 2749
Introduction......Page 2753
Chronic Obstructive Pulmonary  Disease Exacerbation......Page 2754
Hypoxemic Acute Respiratory Failure......Page 2755
Asynchronies During Noninvasive Pressure-Support Ventilation......Page 2756
ICU or Specific NIV Ventilators......Page 2757
Interfaces......Page 2758
Asthma......Page 2759
Choice Between CPAP or Pressure Support  Plus PEEP......Page 2760
NIV for ARDS......Page 2761
Abdominal Surgery......Page 2762
Bronchoscopy......Page 2763
Epidemiology......Page 2764
Special Features of  Obesity-Hypoventilation Syndrome......Page 2765
Importance of Monitoring Home  Noninvasive Ventilation......Page 2766
Epidemiology of Noninvasive Ventilation in Acute Care......Page 2767
Key Readings......Page 2768
References......Page 2769
ECMO Indications and Technology: a Historical Perspective......Page 2775
Indications for Veno-Venous and Arterio-Venous ECMO......Page 2776
Cannulation for  Veno-Venous ECMO......Page 2777
O2 Delivery by the Membrane Lung......Page 2779
Oxygen Uptake from the Native Lung......Page 2781
Monitoring and Management of the Artificial Lung......Page 2782
Ventilatory Management  of the Native Lung......Page 2783
Low-Flow CO2 Removal: Indications and Technology......Page 2784
CO2 Removal for Ultraprotective Ventilation in ARDS......Page 2785
CO2 Removal as Bridge to Transplant see Chapter 106......Page 2786
Key Readings......Page 2787
References......Page 2788
Predicting the Outcome of Respiratory Failure......Page 2790
Where and How Patients Die......Page 2791
Justification for Withholding and Withdrawing Life-Sustaining Therapy......Page 2792
Medical Futility......Page 2794
Justification for Administering Palliative Care......Page 2795
Two Models of the Physician- Patient Relationship......Page 2796
Improving Communication and the Quality of Care at the End of Life......Page 2797
Emotional and  Spiritual SUPPORT......Page 2798
Management of Pain......Page 2799
Management of Dyspnea......Page 2800
What Therapies Are Withheld  and Withdrawn......Page 2801
Acknowledgments......Page 2802
Key Readings......Page 2803
References......Page 2804
Definition and Goals......Page 2807
History......Page 2808
Indications......Page 2809
Exercise Training......Page 2810
Education......Page 2811
Breathing Training, Inspiratory Muscle Training, and Chest Physical Therapy......Page 2812
Dosage......Page 2813
Pulmonary Rehabilitation and  the Integrated Care of the  Respiratory Patient......Page 2814
Outcome Assessment......Page 2815
Advance Care Planning......Page 2816
Key Readings......Page 2817
References......Page 2818
Indications and Candidate Selection......Page 2821
Allocation System......Page 2822
Bridging to Transplantation: Artificial Lung Technologies......Page 2823
Lung Preservation......Page 2824
Routine Posttransplantation Management and Outcomes......Page 2825
Survival......Page 2826
Pulmonary Function......Page 2827
Primary Graft Dysfunction......Page 2828
Airway Complications......Page 2829
Cytomegalovirus......Page 2830
Aspergillus......Page 2831
Acute Cellular Rejection......Page 2832
Acute Antibody-Mediated Rejection......Page 2833
Bronchiolitis Obliterans Syndrome......Page 2834
Posttransplantation Lymphoproliferative Disorder......Page 2835
Recurrence of Primary Disease......Page 2836
Future Directions......Page 2837
eFigure Image Gallery......Page 2839
Key Readings......Page 2838
References......Page 2842
Descriptors of Forced  Breathing Maneuvers......Page 2847
Volume-Pressure Relationships......Page 2848
Gas to Blood......Page 2849
V. Other Useful Terms  and Equations......Page 2850
A......Page 2851
B......Page 2856
C......Page 2859
D......Page 2868
E......Page 2871
F......Page 2874
G......Page 2875
H......Page 2876
I......Page 2879
L......Page 2882
M......Page 2885
N......Page 2889
O......Page 2892
P......Page 2894
R......Page 2904
S......Page 2907
T......Page 2910
U......Page 2914
V......Page 2915
W......Page 2917
Z......Page 2918