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<title>麻酔科医に必要な周術期呼吸管理 | 株式会社文光堂</title>


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<meta name="description" content="シリーズ第3巻は，術中の麻酔管理に重要な「呼吸管理」について必要な最新知識を解説．近年，人工呼吸器の性能は飛躍的に向上し，様々なモニタリング機能やモードが追加された．便利になった反面，本来の適切な設定方法で見るべきポイントが忘れられてきている．本書では，呼吸管理に苦手意識を持つ麻酔科医や若手麻酔科医でも適切に理解して呼吸管理ができるよう，必ず押さえておきたい情報を厳選解説．人工呼吸器，気道確保デバ">

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		<h1 class="catchCopy">若手麻酔科医でも最新･最適の呼吸管理を取得できる！人工呼吸器を理解して使えるようになる!!</h1>
		

		<h2 class="series">麻酔科プラクティス&nbsp;&nbsp;3</h2>
		
		<h1 class="title">麻酔科医に必要な周術期呼吸管理<span class="version"></span></h1>
		

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					編集：佐藤暢一（東邦大学）
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					<span class="transparent">責任編集</span>　水本一弘（和歌山県立医科大学）
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					<span class="transparent">責任編集</span>　佐藤暢一（東邦大学）
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				<ul class="property"><li class="disc">B5判・272頁・4色刷</li><li class="disc">ISBN&nbsp;978-4-8306-2849-8</li><li class="disc">2020年12月10日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">シリーズ第3巻は，術中の麻酔管理に重要な「呼吸管理」について必要な最新知識を解説．近年，人工呼吸器の性能は飛躍的に向上し，様々なモニタリング機能やモードが追加された．便利になった反面，本来の適切な設定方法で見るべきポイントが忘れられてきている．本書では，呼吸管理に苦手意識を持つ麻酔科医や若手麻酔科医でも適切に理解して呼吸管理ができるよう，必ず押さえておきたい情報を厳選解説．人工呼吸器，気道確保デバイスを理解して使えるようになる．呼吸管理の最新の考えかた，人工呼吸器のモードや画面の見かた，術前評価のポイントがわかる．また，本書に満載，最前線で臨床に携わる麻酔科医によるアドバイス「Clinical Pearls」は必ず実践で役立つはず．<br><br>【シリーズの特徴】<br>現在の麻酔科臨床で特に注目の集まるトピックスや新たな課題を厳選し，フルカラーの誌面でビジュアルに整理・解説．若手からベテラン麻酔科医までを対象とし，臨床で役立つ最新かつ最良の意義深いテーマを提供する．</section><section class="preface">「麻酔科医に必要な周術期呼吸管理」序文<br><br>　30年近く前に私が麻酔科医になった頃は，「ICUや人工呼吸器の管理といえば麻酔科医」という時代でした．いまでも他科の医師から人工呼吸器管理について相談を受けることはよくあることだと思います．しかし現在の麻酔科医の仕事は全身管理だけでなく，ペインクリニックをはじめとする疼痛管理や緩和医療など多様化し，若手，ベテランを問わず，麻酔科医のなかでもサブスペシャリティに対する興味はひとそれぞれになりました．そのため，呼吸管理に興味を持っていなかったり，苦手に感じている麻酔科医も増えていると感じます．その間に人工呼吸器の性能は飛躍的に向上して，さまざまなモードやモニタリング機能が付加されました．以前は患者との同調性を考えて細かく設定しなければファイティングして困った症例でも，おおよその設定であれば呼吸器の性能でカバーしてくれるようになり，便利にもなった反面，本来の適切な設定方法で見るべきポイントが忘れられてもきています．また，人工呼吸器の性能を生かして適切な管理を行うには機能が増えすぎて，普段から呼吸管理に精通している医師でないと理解が難しくなっている面もあり，せっかくの最新機能も，わからないために不必要と切り捨ててしまいかねません．陽圧人工呼吸管理の概念も変化し，Open Lung Approachや，吸入酸素濃度の考え方など，従来の呼吸管理では肺だけでなく全身状態に悪影響を及ぼす可能性も指摘されています．いまでは，ICUで得られた知見が手術中の呼吸管理にも応用されるようになってきてはいますが，十分なバックグラウンドの理解なく「1回換気量6～8mL/kg」など，一部の情報だけがひとり歩きしており，どうしてそれが必要なのかを知る機会も欠如しているのではないかと思います．<br>　麻酔科医の働き方が多様化し，活躍の場が呼吸とは無縁のサブスペシャリティ領域となったとしても，術中の麻酔管理は変わらず麻酔科医の本分であり，そこでは呼吸管理が必ず必要となります．集中治療を専門としなくても，ICUでの術後呼吸器管理に繋げるためには，術中も新しい考えに裏打ちされた呼吸管理の知識が必要であることは間違いありません．本書は，呼吸管理に精通した麻酔科医の先生方に，若手麻酔科医がいま知っておくべき知識をわかりやすくまとめていただきました．本書が，呼吸管理に興味のない麻酔科医も適切な最新の呼吸管理ができるようになるために，わかりやすい周術期呼吸管理のバイブルとなることを希望しています．<br><br>2020年11月<br>東邦大学　佐藤暢一</section><section class="indexes">Ⅰ　呼吸生理の基礎<br>　１　麻酔科専門医に必要な呼吸生理の知識<br><br>Ⅱ 術前評価<br>　1　身体所見の見かた<br>　2　胸部X線検査の見かた<br>　3　呼吸機能検査の読みかた<br>　4　動脈血液ガス分析<br><br>Ⅲ　気道確保<br>　1　喉頭展開デバイス<br>　2　気道確保デバイス<br>　3　困難気道の対応<br>　4　観血的気道確保の方法<br><br>Ⅳ　酸素療法<br>　1　酸素療法の基本<br>　2　HFNC，NPPV<br><br>Ⅴ　呼吸器デバイスの基本構造<br>　1　麻酔器の基本構造<br>　2　麻酔用人工呼吸器の基本構造<br>　［T］最近の麻酔器と低流量麻酔支援機能<br><br>Ⅵ　医療ガスの基礎知識<br>　1　医療ガスの種類<br><br>Ⅶ　人工呼吸モード<br>　1　PCVとVCV<br>　2　基本的な換気モードA/C<br>　3　基本的な換気モードSIMV<br>　4　基本的な換気モードPSV<br>　5　特殊なモード<br>　6　ECMOの基本コンセプト<br>　7　NO吸入療法<br><br>Ⅷ　人工呼吸器管理の考えかた<br>　1　肺保護換気<br>　2　自発呼吸 VS 陽圧換気　利点と欠点<br>　［OPA］食道内圧と経肺圧<br>　3　術中呼吸管理の考えかた<br>　4　換気設定<br>　［B］PEEPの設定方法<br>　5　抜管の基準<br>　6　離脱に難渋する患者の離脱戦略<br>　7　加温加湿，人工鼻<br>　8　小児の人工呼吸器管理<br>　9　人工呼吸中のモニタリング<br>　10　グラフィックモニター<br>　11　コンプライアンスとレジスタンス<br>　［OPA］CO<sub>2</sub>モニタリングの重要性―monitored anesthesia care―<br>　12　人工呼吸と肺エコー<br>　［T］electrical impedance tomography（EIT）<br><br>Ⅸ　合併疾患を有する患者の術中管理<br>　1　慢性閉塞性肺疾患，気管支喘息<br>　2　間質性肺炎<br>　3　肥満，睡眠時無呼吸症候群<br>　［OPA］筋萎縮性側索硬化症（ALS）患者の胃瘻造設管理<br><br>Ⅹ　手術と呼吸管理　各論<br>　1　腹腔鏡手術の呼吸管理<br>　2　呼吸器外科手術の呼吸管理<br>　3　母体の周術期呼吸管理<br><br>Ⅺ　合併症とその管理<br>　1　無気肺，気胸・血胸，誤嚥性肺<br><br>Ⅻ　呼吸器関連リハビリテーション<br>　1　術前呼吸訓練<br>　2　術後リハビリテーション<br><br>略語表<br>索　引<br><br>［T］＝Topics<br>［B］＝Basic<br>［OPA］＝One Point Advice</section></article>
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