Over the last 10 years the syndrome of severe acute renal failure has progressively changed in its epidemiology. It is now most frequently seen in critically ill patients, typically in the context of sepsis and multiorgan failure. This epidemiologic change has meant that intensive care physicians and nephrologists must now work in close cooperation at all times and must take many com plex issues of prevention, pathogenesis, and management into account that they did not previously have to tackle. Simultaneously, the last 10 years have seen the development of major technical and conceptual changes in the field of renal replacement therapy. There are now previously unavailable therapeutic options that provide physicians with a flexible and rapidly evolving armamentarium. The nutrition of these patients, previously limited by the par tial efficacy of renal replacement therapies, has also become more aggressive and more in tune with the needs of critically ill patients. Increased understanding of the pathogenesis of the multi organ failure syndrome has focused on the role of many soluble "mediators of injury" (cytokines, leukotrienes, prostanoids etc.). These molecules are likely to participate in the pathogenesis of acute renal failure. Their generation and disposal is also affected by different techniques of artificial renal support."

Bridging the gap between medical and surgical specialties in critical care, Textbook of Critical Care, 8th Edition, offers a practical, multidisciplinary approach to the effective management of adult and pediatric patients in the ICU. An outstanding editorial team, led by world-renowned intensivist Dr. Jean-Louis Vincent, assisted by Dr. Frederick A. Moore and new editors Drs. Rinaldo Bellomo and John J. Marini, provides the evidence-based guidance you need to overcome a full range of practice challenges. A full-color art program, relevant basic science and key summary points in every chapter, and expert contributing authors from all over the world make this an indispensable resource for every member of the critical care team. Provides a concise, readable understanding of the pathophysiology of critical illness and new therapeutic approaches to critical care.  Addresses both medical and surgical aspects in critical care for adult and pediatric patients in one comprehensive, easy-to-use reference.  Shares the knowledge and expertise of the most recognized and trusted leaders in the field, with more international contributing authors than in previous editions.  Covers new information on procedural and diagnostic ultrasound, prone positioning, ECMO, and VADs.  Discusses key topics such as organ support, telemedicine, echocardiography, antibiotic stewardship, antiviral agents, coagulation and anti-coagulation, and more.  Features a wealth of tables, boxes, algorithms, diagnostic images, and key points that clarify important concepts and streamline complex information for quick reference.  Includes companion videos and exclusive chapters online that cover commonly performed procedures.  Takes a multidisciplinary approach to critical care, with contributions from experts in anesthesia, surgery, pulmonary medicine, and pediatrics.  Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices. 

The 2nd edition of this book describes the recent techniques, strategies, and drugs that have been demonstrated by multicenter randomized trials to influence survival in critically ill, defined as those who have acute failure of at least one organ, due to either a pathological condition or a medical intervention, and require intensive care treatment. Each chapter focuses on a specific procedure, device, or drug. The scope is accordingly wide, with coverage of topics as diverse as noninvasive mechanical ventilation, protective ventilation, prone positioning, intravenous salbutamol in ARDS, high-frequency oscillatory ventilation, mild hypothermia after cardiac arrest, daily interruption of sedatives, tranexamic acid, diaspirin cross-linked hemoglobin, albumin, growth hormone, glutamine supplementation, tight glucose control, supranormal oxygen delivery, and hydroxyethyl starch in sepsis. The topics selection was performed with the help of hundreds of specialists from dozens of countries; they expressed via web if they agreed or not with these topics and if they used them in their daily clinical practice. The clear text is supported by "how to do" sections and "key point" boxes that provide easily accessible practical information. Written by acknowledged international experts, Reducing Mortality in Critically Ill Patients is of interest for a wide variety of specialists, including intensivists, emergency doctors, and anesthesiologists.

Comprehensive and clinically relevant, the 3rd Edition of Critical Care Nephrology provides authoritative coverage of the latest advances in critical care procedures for patients with renal diseases or disorders. Using common guidelines and standardized approaches to critically ill patients, this multidisciplinary reference facilitates better communication among all physicians who care for critically ill patients suffering from kidney disease, electrolyte and metabolic imbalances, poisoning, severe sepsis, major organ dysfunction, and other pathological events. Offers detailed discussions of different forms of organ support, artificial organs, infections, acute illness occurring in chronic hemodialysis patients, and much more. Places a special emphasis on therapeutic interventions and treatment procedures for a hands on clinical reference tool. Presents information clearly, in a format designed for easy reference - from basic sciences to clinical syndromes to diagnostic tools. Covers special populations such as children, diabetic patients, and the elderly. An exceptional resource for nephrologists, intensivists, surgeons, or critical care physicians - anyone who treats critically ill renal patients. Shares a combined commitment to excellence lead by Drs. Claudio Ronco, Rinaldo Bellomo, John Kellum, and Zaccaria Ricci - unparalleled leaders in this field. Addresses key topics with expanded coverage of acute kidney injury, stress biomarkers, and sepsis, including the latest developments on mechanisms and management. Provides up-to-date information on extracorporeal therapies from new editor Dr. Zaccaria Ricci. Expert ConsultT eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.

The latest edition of this text is the go-to book on rapid response systems (RRS). Thoroughly updated to incorporate current principles and practice of RRS, the text covers topics such as the logistics of creating an RRS, patient safety, quality of care, evaluating program results, and engaging in systems research. Edited and written by internationally recognized experts and innovators in the field, Textbook of Rapid Response Systems: Concepts and Implementation, Second Edition is a valuable resource for medical practitioners and hospital administrators who want to implement and improve a rapid response system.

Continuous Renal Replacement Therapy (CRRT) is the standard of care for management of critically ill patients with acute renal failure. Part of the Pittsburgh Critical Care series, Continuous Renal Replacement Therapy provides concise, evidence-based, bedside guidance about this treatment modality, offering quick reference answers to clinicians' questions about treatments and situations encountered in daily practice. Organized into sections on theory, practice, special situations, and organizational issues, this volume provides a complete view of CRRT theory and practice. Tables summarize and highlight key points, and key studies and trials are included in each chapter. The second edition has been updated to include a new chapter on the use of biomarkers to aid in patient selection and timing, extensive revisions on terminology and nomenclature to match current standards, and the most up-to-date information on newly developed CRRT machines.

Why Critical Care Evolved METs? In early 2004, when Dr. Michael DeVita informed me that he was cons- ering a textbook on the new concept of Medical Emergency Teams (METs), I was surprised. At Presbyterian-University Hospital in Pittsburgh we int- duced this idea some 15 years ago, but did not think it was revolutionary enough to publish. This, even though, our fellows in critical care medicine training were all involved and informed about the importance of "C- dition C (Crisis)," as it was called to distinguish it from "Condition A (Arrest). "We thought it absurd to intervene only after cardiac arrest had occurred, because most cases showed prior deterioration and cardiac arrest could be prevented with rapid team work to correct precluding problems. The above thoughts were logical in Pittsburgh, where the legendary Dr. Peter Safar had been working since the late 1950s on improving current resuscitation techniques, ?rst ventilation victims of apneic from drowning, treatment of smoke inhalation, and so on. This was followed by external cardiac compression upon demonstration of its ef?ciency in cases of unexpected sudden cardiac arrest. Dr. Safar devoted his entire professional life to improvement of cardiopulmonary resuscitation. He and many others emphasized the importance of getting the CPR team to o- of-hospital victims of cardiac arrest as quickly as possible.

This issue of Critical Care Clinics, Guest Edited by Dr. Rinaldo Bellomo, focuses on Modern Critical Care Endocrinology. Article topics include: Diabetes insipidus and SIADH in the ICU; Estrogen therapy in ICU patients; The angiotensin family, ACE and ACE 2; Angiotensin II in vasodilatory shock; Vasopressin in vasodilatory shock; Hydrocortisone in vasodilatory shock; Erythropoietin in trauma and critical illness; HbA1c and permissive hyperglycemia in diabetic ICU patients; Osteoporosis and the critically ill patient; New oral agents for the treatment of diabetes; Melatonin in critical care; The incretins in ICU patients; Hepcidin; Thyroid hormone therapy in the ICU; and Hormonal therapy in organ donors.