Inflammation in itself is not to be considered as a disease . . . and in disease, where it can alter the diseased mode of action, it likewise leads to a cure; but where it cannot accomplish that solitary purpose . . . it does mischief - John Hunter, A Treatise on the Blood, ITfIlammation, and Gunshot Woundr (London, 1794)1 As we reached the millennium, we recognized the gap between our scientific knowledge of biologic processes and our more limited clinical capabilities in the care of patients. Our science is strong. Molecular biology is powerful, but our therapy to help patients is weaker and more limited. For this reason, this book focuses on the problems of multiple organ failure (MOF), multiple organ dysfunction syndrome (MODS), and systemic inflammatory response syndrome is, patients who have severe injuries; require major, (SIRS) in high-risk patients, that overwhelming operations; or have serious illnesses requiring intensive care; patients who have diseases elsewhere, in other organs or systems, that limit their capabilities to survive a new insult; and patients who are elderly or at high risk for sepsis or other complications. These are the patients who need our help. They need the advances in science, in molecular biology, immunology, pathophysiology, biochemistry, genetics, high technology, and other areas of maximum support at the bedside. These advances could potentially have the greatest impact on improving patient care.

This book on post-injury multiple organ failure (MOF) offers a comprehensive overview and clinically focused practical guide to treating the condition. MOF is arguably the most difficult complication to manage in polytrauma patients and is responsible for the majority of trauma deaths among patients who survived the first 24 hours after injury. Beyond mortality, it has a major impact on healthcare resource utilization and a persistent negative effect on patients’ long-term reported outcomes. This book is edited by surgeons who are passionate about the topic, and about optimizing the outcomes for polytrauma patients. Grasping the fascinating pathophysiology of MOF is essential for providing patients with quality early care. Each chapter highlights key learning objectives, historical perspectives, diagnostic and therapeutic pearls, and includes a must-know summary, additional reading suggestions and future research directions. Flowcharts, decision-making guides, summary tables, graphics and clinical photographs help to maximize the learning experience and to ensure readers retain what they’ve learned. The book fills a unique niche area for many specialties dedicated to critical care of polytrauma patients and to their management before and beyond intensive care.

In this book current knowledge of the pathophysiology of shock, sepsis and multi organ failure is presented. The rapid progress which has been made and the results achieved in intensive care medicine are based on sound basic research, which is duly reflected in these chapters. Multiorgan failure is the foremost cause of postoperative and posttraumatic death and many complex mechanisms are involved. Only with a good foundation of basic research can abnormalities in the physiological, biochemical, and morphological course of shock be recognized and the necessary conclusions for treatment drawn. Therapy must proceed from profound knowledge of the multi variant physiological events in order to influence shock, sepsis and organ failure. Although numerous possibilities for therapy have arisen from pharmaceutical research in recent years, they are beyond the scope of this book and are not discussed here. To gain a better understanding of the pathophysiological events it was necessary to examine and to describe different models that simulate and reproduce these events. Here we describe the causative agents (shock) and the consequences (sepsis, organ failure) in two main sections, divided on the basis of their pathophysiology.

Improving standards of care is a real challenge in Intensive Care Medicine. Bettering clinical performance, patient safety, risk management and audit represents the cornerstone for raising the quality of care in ICU patients. Communication is the platform from where to start to reach a consensus in an extremely crowded area, a unique multidisciplinary and multiprofessional environment in which quality of care and, ultimately, patient survival need to be ameliorated.

Developed in conjunction with the Australian College of Critical Care Nurses (ACCCN), the text has been written and edited by the most senior and experienced critical care nursing clinicians and academics across the region. ACCCN's Critical Care Nursing is a resource that will foster the development of skilled and confident critical care nurses. This comprehensive text provides detailed coverage of a number of specialty areas within critical care nursing including intensive care, emergency nursing, cardiac nursing, neuroscience nursing and acute care. It will encourage students to be reflective practitioners, ethical decision-makers and providers of evidence-based care. Written by expert clinicians, academics, and educators Pedagogically rich chapters with learning objectives, key terms, case studies, practice tips, article abstracts, learning activities, research vignettes Heavily illustrated and referenced Reflects current clinical practice, policies, procedures and guidelines The text has a patient-centred approach and will provide students with a sound knowledge base and critical thinking skills Image bank of all illustrations from the text will be available to lecturers for teaching

The revision of this text provides up-to-date information on the science of multiple organ dysfunction syndrome (MODS). This edition brings not only new science but new nomenclature based on the recommendations of the American College of Chest Physicians and the Society of Critical Care Medicine Consensus Conference. The text gives the experienced critical care practitioner the pathophysiologic background and understanding of MODS necessary to develop an effective plan of care and anticipate events associated with this yndrome. The focus is on integration of clinical assessment with pathophysiological knowledge so the decision-making process is based on a scientific and research foundation.

This is the definitive, gold-standard text on sepsis and multiple-organ dysfunction. It is comprehensive and thoroughly referenced: the one text in which all current knowledge on this important topic is brought together. The book is written by a team of international contributors, overseen by an internationally acclaimed editorial team.