Metabolic Alkalosis Metabolic acidosis gets all the headlines, but metabolic alkalosis is the most common acid-base disorder in hospitalized patients (1,2,3). The prevalence of metabolic alkalosis can be attributed to…

Organic Acidoses This chapter describes two clinical disorders that involve excessive production of organic (carbon-based) acids by intermediary metabolism. Both of these disorders, lactic acidosis and ketoacidosis, can be adaptive…

Acid-Base Analysis This chapter describes how to identify acid-base disorders using the pH, PCO2 and bicarbonate (HCO3) concentration in blood. Included are: (a) simple rules for the identification of primary,…

Discontinuing Mechanical Ventilation This chapter describes the process of removing patients from mechanical ventilation (also called weaning from mechanical ventilation), and the difficulties that can occur during the transition to…

The Ventilator-Dependent Patient This chapter describes the daily care and concerns for ventilator-dependent patients, with emphasis on the artificial airways (endotracheal and tracheostomy tubes) and mechanical complications of positive pressure…

Alternative Modes of Ventilation This chapter describes alternative methods of ventilatory support when conventional mechanical ventilation is not sufficient, or may not be necessary. Included are rescue modes of ventilation…

Conventional Mechanical Ventilation There are 174 methods of positive pressure ventilation (1), yet in the 50-plus years since positive pressure ventilation was introduced, the only method that has improved clinical…

Asthma and COPD in the ICU This chapter describes the management of acute exacerbations of asthma and chronic obstructive pulmonary disease (COPD), including the use of noninvasive and invasive ventilatory…

Acute Respiratory Distress Syndrome The condition described in this chapter, which has the nondescript name acute respiratory distress syndrome (ARDS), is a diffuse inflammatory injury of the lungs that is…

Ventilator-Associated Pneumonia The clinical approach to pneumonia can be characterized by one word: problematic. Fundamental problems include a limited ability to detect parenchymal lung infections, and the lack of a…