Critical care medicine is a dynamic and exciting arena where complex
pathophysiologic states require exten-sive knowledge and up-to-date clinical
information. An extensive knowledge of basic pathophysiology, as well as
awareness of the appropriate diagnostic tests and treatments that are used to
optimize care in the critically ill is essential. Since our first edition 7 years ago,
new information crucial to the care and understanding of the critically ill patient
has rapidly accumulated. Because this knowledge base crosses many different
disciplines, a comprehensive multidisciplinary approach presenting the
information is essential, similar to the multidisciplinary approach that is used to
care for the critically ill patient. We have strived to provide this content in an
easily digestible format that uses a variety of teaching tools to facilitate
understanding of the presented concepts and to enhance information retention.
To meet the demand to provide comprehensive and diverse education in order
to understand the pathoge-nesis and optimum care of a variety of critical
illnesses, we have substantially revised the prior topics in the first edition with
updated information. We have also markedly expanded the number of topics
covered to include acute lung injury and the acute respiratory distress syndrome,
an expanded discussion of the physiology and operation of mechanical
ventilation, obstetrical care in the ICU, neurosurgical emergencies, acute
coronary syndromes, cardiac arrhythmias, role of whole body rehabilitation in
the ICU, ethical conduct of human research in the ICU, and nursing care of the
ICU patient. Nurses, physical and respiratory therapists, nutritionists, and
pharmacists have contributed to the efforts of surgeons, anesthesiologists,
radiologists, cardiologists, pulmonary and critical care physicians, and other
healthcare professionals to provide the complete and up-to-date information that
is presented in this second edition. This text should be useful not only for the
internist, anesthesiologist, or surgeon who practices in the ICU, but also for the
nurses, therapists, and other ancillary professionals who care for the ICU patient.
This second edition is also designed to make the dynamic environment of the
critical care unit understanda-ble and the approach to the patient both logical and
successful. The book continues to build on the three main components presented
in the first edition: (1) the description of the procedural tasks commonly
performed for the critically ill patient, (2) explanations of the most common
pathophysiologic states encountered, and (3) descriptions of specific disease
entities with details regarding their differential diagnosis, diagnostic strategy,
and therapeutic plan.This book also uses several educational approaches that we have found useful
in our own teaching sessions and prior textbooks. Clinical cases introduce
chapters and highlight chapter segments to emphasize clinical relevancy. As an
additional study aid, margin notes highlight important teaching points and
facilitate easy review of the chapter content. To consolidate the principles
outlined in each chapter, review questions with full-text explanations are
provided at the end of each chapter. In this second edition, we have added in-text
referencing for sentinel papers and also provided a suggested reading list at the
end of each chapter. All these elements help reinforce the most important
messages for the reader and provide ready sources of information for further
self-education.
This textbook is the effort of many individuals across many disciplines who
practice at Temple University School of Medicine and Temple University
Hospital. Nonetheless, only evidence-based literature is used to provide the basic
concepts and therapeutic and diagnostic strategies presented; the content does
not represent the convention of care endorsed by any single institution.
We hope that you find the information helpful in your understanding of
critical illnesses and the current evi-dence-based approaches to the care of the
ICU patient.