Nicola Vargas – författare

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 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.