Critical Care Medicine: Principles of Diagnosis and Management in the Adult, 4e

Book Preface

Few fields in medicine have grown, evolved, and changed as rapidly as critical care medicine has during the past 40 years. From its origins in the postoperative recovery room and the coronary care unit, the modern intensive care unit (I CU) now represents the ultimate example of medicine’s ability to supply the specialized personnel and technology necessary to sustain and restore seriously ill persons to productive lives. While the field continues to evolve rapidly, sufficient principles, knowledge, and experience have accumulated in the past few decades to warrant the production of a textbook dedicated to adult critical care medicine. We chose to limit the subject mater of our book to the critical care of adult patients to allow the production of a comprehensive textbook in a single volume.

This book was envisioned to be multidisciplinary and multiauthored by acknowledged leaders in the field but aimed primarily at practicing critical care physicians who spend the beer part of their time caring for patients in an I CU. Thus, the book would be appropriate for critical care internists as well as for surgical or anesthesia critical care specialists. The goal was to produce the acknowledged “best practice” standard in critical care medicine.

The first edition of the textbook was published in 1995, co-edited by J oe Parrillo and Roger Bone. The book sold exceedingly well for a first edition text. A fter the untimely death of Roger Bone in 1997, Phil D ellinger joined J oe Parrillo as the co-editor for the second, third, and now this fourth edition. A s co-editors, we have labored to produce a highly readable text that can serve equally well for comprehensive review and as a reference source. We felt that it was important for usability and accessibility to keep the book to a single volume. This was a challenge, because critical care knowledge and technology have expanded significantly during the past decade. By placing emphasis on clear, concise writing and keeping the focus on critical care medicine for the adult, this goal was achieved.

Our view of critical care medicine is mirrored in the organization of the textbook. Modern critical care is a multidisciplinary specialty that includes much of the knowledge and technology contained in many disciplines represented by the classic organ-based subspecialties of medicine, as well as the specialties of surgery and anesthesiology. The book begins with a section consisting of chapters on the technology, procedures, and pharmacology that are essential to the practicing critical care physician. This section is followed by sections devoted to the critical care aspects of cardiovascular, pulmonary, infectious, renal, metabolic, neurologic, gastrointestinal, and hematologic-oncologic diseases. S ubsequent chapters are devoted to important social, ethical, and other issues such as psychiatric disorders, severity of illness scoring systems, and administrative issues in the I CU. This fourth edition has significant content additions and revisions, including a new chapter devoted to bedside I CU ultrasound. O nline videos are also available featuring a variety of content areas, including echocardiograms and bedside ultrasounds of a variety of exam sites. Each chapter is designed to provide a comprehensive review of pertinent clinical, diagnostic, and management issues. This is primarily a clinical text, so the emphasis is on considerations important to the practicing critical care physician; also presented, however, are the scientific (physiologic, biochemical, and molecular biologic) data pertinent to the pathophysiology and management issues. We have aimed for a textbook length that is comprehensive but manageable. S ubstantial references (most now online) are provided for readers wishing to explore subjects in greater detail. We have identified key points and key references to highlight the most important issues within each chapter. Continued popular features of this fourth edition include a color-enhanced design and clinically useful management algorithms.

We have been fortunate to a?ract a truly exceptional group of authors to write the chapters for Critical Care Medicine: Principles of D iagnosis and Management in the Adul tF. or each chapter, we have chosen a seasoned clinician-scientist actively involved in critical care who is one of a handful of recognized experts on his or her chapter topic. We have continued the international flavor of our authorship. To provide uniformity in content and style, one or both of us have edited and revised each chapter.

We wish to thank the highly dedicated people who provided us with the assistance needed to complete a venture of this magnitude. Our thanks go to Linda Rizzuto, who provided valuable organizational and editorial input; to Ellen Lawlor, for her administrative assistance; and to the excellent editorial staff at Elsevier, including William Schmitt, Janice Gaillard, and Sharon Corell.