Oxford Textbook of Critical Care

1 RESUSCITATION; 1.1 Respiratory management; 1.1.1 Basic airway management: J.M Field and P.J.F Baskett; 1.1.2 Indications for intubation: R.F Armstrong; 1.1.3 Restoring ventilation: R.F Armstrong; 1.2 Circulatory Management; 1.2.1 Pathophysiology and causes of cardiac arrest: N. Nichol and C. Robertson; 1.2.2 Cardiac massage: S. Sun and M.H Weil; 1.2.3 Therapeutic strategies during cardiac arrest: W.J Moore and P.J.F Baskett; 1.2.4 Resuscitating and protecting the brain: P. Safar and P.M Kochanek; 1.2.5 Post-resuscitation management: W. Tang and M.H Weil; 1.3 Fluid Management; 1.3.1 Physiology of body fluids: P.L Khimenko and A.E Taylor; 1.3.2 Therapeutic strategy for fluid replacement: M.J Shapiro; 1.3.3 Therapeutic goals: W.C Shoemaker; 1.3.4 The fluid challenge: A.R Webb; 2 THE RESPIRATORY SYSTEM; 2.1 Normal Physiology; 2.1.1 The Respiratory System: G. Hedenstierna and H.U Rothen; 2.2 Upper airway obstruction; 2.2.1 Airway control and upper airway obstruction: P.D Cameron and P.V van Heerden; 2.3 The breathless patient; 2.3.1 Control of breathing: H. Burchardi and D.W Richter; 2.3.2 Control of breathing: external influences and abnormalities: H. Burchardi and C.-P.Criee; 2.3.3 Causes of breathlessness: S. Benito; 2.3.4 Therapeutic approach to breathlessness: S. Benito; 2.4 Acute respiratory failure; 2.4.1 Hypoventilation: J. Milic-Emili and T. Similowski; 2.4.2 Pathophysiology of acute respiratory distress syndrome and acute lung injury; 2.4.3 Pulmonary mechanical dysfunction: J. Milic-Emili and T. Similowski; 2.4.4 Cardiovascular interactions: M.R. Pinsky; 2.4.5 Therapeutic strategy: M. Sair and T.W Evans; 2.5 Severe Hypoemia; 2.5.1 Pathophysiology and causes: C.W Hanson and B.E Marshall; 2.5.2 Therapeutic approach: L. Gattinoni and D. Chiumello; 2.6 Aspiration and inhalation; 2.6.1 Aspiration of gastric contents: G.J Bellingan; 2.6.2 Inhalational injury: D.T Harrington and B.A Pruitt Jr; 2.7 Acute bronchospasm; 2.7.1 Pathophysiology and causes: M.-D Schaller and D. Tagan; 2.7.2 Therapeutic approach to bronchospasm and asthma: K.M Nolan and C.S Garrard; 2.8 Acute on chronic airflow limitation; 2.8.1 Pathphysiology: R. Fernandez and A. Artigas; 2.8.2 Therapeutic strategy: P.Jolliet and J.-C Chevrolet; 2.9 Respiratory acidosis; 2.9.1 Pathophysiology and causes: L. Gattinoni and A. Lissoni; 2.9.2 Therapeutic Strategy: L. Gattinoni and A. Lissoni; 2.10 Respiratory alkalosis; 2.10.1 Pathophysiology: J.-C Chevrolet and R. Zurcher Zenklusen; 2.10.2 Causes and therapeutic strategy: J.-C Chevrolet and R. Zucher Zenklusen; 2.11 Failure to wean from mechanical ventilation; 2.11.1 Pathophysiology of respiratory muscle dysfunction: M. Aubier; 2.11.2 Pathophysiology cardiorespiratory interactions: M. R Pinsky; 2.11.3 Increased work of breathing: R. Dhand and M.J Tobin; 2.11.4 Causes of failure to wean: T.E Oh; 2.11.5 Therapeutic approach: T.E Oh; 2.12 Acute pneumonia; 2.12.1 Pathophysiology: J. Rello and A. Torres; 2.12.2 Causes and diagnosis of severe community-acquired pneumonia: J. Dorca and A. Torres; 2.12.3 Causes and diagnosis of nosocomial pneumonia: J. Dorca and A. Torres; 2.12.4 Therapeutic approach: A. Torres and M. El-Ebiary; 2.13 Viral pneumonitis and atypical pneumonia; 2.13.1 Pathophysiology and causes: J.-F Timsit and J. Carlet; 2.13.2 Therapeutic approach: J.-F Timsit and J. Carlet; 2.14 Pneumothorax; 2.14.1 Pathophysiology of pneumothorax: M. Sydow; 2.14.2 Assessment and management: R.C Tilley and B.F Keogh; 2.14.3 Management of bronchial fistulas - pleural, esophageal, and aortic: E.S Kassis and J.D Luketich; 2.15 Pleural effusion; 2.15.1 Pathophysiology of pleural effusion: H.T Billy and K. Waxman; 2.15.2 Indications for drainage of pleural effusion: B.K Evetts and K. Waxman; 2.15.3 Drainage techniques: R. Nirula and K. Waxman; 2.15.4 Management of hemothorax: J.A McGuigan; 2.16 Atelectasis and sputum retention; 2.16.1 Pathophysiology of sputum retention: F. Potie and C. Martin; 2.16.2 Conditioning of inhaled respiratory gases: L. Thomachot and C. Martin; 2.16.3 Therapeutic approach: R. Vialet and C. Martin; 2.17 Hemoptysis; 2.17.1 Pathophysiology and causes: R. Zurcher Zenklusen and P. Jolliet; 2.17.2 Therapeutic approach: R. Zurcher Zenklusen and P. Jolliet; 3 Cardiovascular system; 3.1 Normal Physiology; 3.1.1 The cardiovascular system: B.A Foex and R.A Little; 3.2 Acute chest pain; 3.2.1 Causes and diagnosis of chest pain: J.R McEwan; 3.2.2 Diagnosis and management of angina pectoris: J.R McEwan; 3.3 Acute Myocardial Infarction; 3.3.1 Pathophysiolgy: M.J Davies; 3.3.2 Diagnosis: P. Sleight; 3.3.3 Management: P. Sleight; 3.4 Aortic Dissection; 3.4.1 Pathophysiology: J. Salmon; 3.4.2 Diagnosis: J. Salmon and L.J Jarvis; 3.4.3 Management: J. Salmon; 3.5 The hypotensice patient; 3.5.2 Causes: A. Sielenkamper and W.J Sibbald; 3.5.3 Therapeutic strategy: A Sielenkamper and W.J Sibbald; 3.6 Cardiac failure; 3.6.1 Pathophysiology of myocardial failure and the systemic circulatory response: M. Singer; 3.6.2 Therapeutic strategy: M. Singer; 3.7 Tachyarrhythmias; 3.7.1 Causes and diagnosis: M.C Sayers and C.M Gasperetti; 3.7.2 Therapeutic strategy: M.C Sayers and C.M Gasperetti; 3.8 Bradyarrhythmias; 3.8.1 Causes and diagnosis: C.M Gasperetti and M.C Sayers; 3.8.2 Therapeutic strategy: C.M Gasperetti and M.C Sayers; 3.9 Endocarditis; 3.9.1 Pathophysiology and causes: A.P.R Wilson; 3.9.2 Prevention: A.P.R Wilson; 3.9.3 Treatment: A.P.R Wilson; 3.10 Severe hypertension; 3.10.1 Pathophysiology and causes: E.A Panacek; 3.10.2 Management: E.A Panacek; 3.11 Severe capillary leak; 3.11.1 Pathophysiology: T.M Moore and A.E Taylor; 3.11.2 management of non-cardiogenic pulmonary edema: L. Oppenheimer; 3.12 Pericardial tamponade; 3.12.1 Pathophysiology and causes: W.C Shoemaker; 3.12.2 Management: W.C Shoemaker; 3.13 Pulmonary hypertension; 3.13.1 Pathophysiology and causes: D. Pappert and K.J Falke; 3.13.2 Management: R. Rossaint and K. Falke; 3.14 Pulmonary vascular obstruction; 3.14.1 Capillary occlusion: B. Zwissler and K. Messmer; 3.14.2 Pulmonary embolus: E.P Wilsonand R.A White; 4 The gastrointestinal and hepatic system; 4.1 Normal physiology; 4.1.1 The gastrointenstinal system: U. Haglund; 4.1.2 The hepatic system: S. Beloucif and D.M Payen; 4.2 Gastrointestinal hemorrhage; 4.2.1 Upper gastrointestinal hemorrhage: H.J Dworken; 4.2.2 Variceal bleeding: H.J Dworken; 4.2.3 Lower gastrointestinal hemorrhage: H.J Dworken; 4.3 The acute abdomen; 4.3.1 Perforated viscus: J.W.M Greve and G. Ramsay; 4.3.2 Ischemic bowel: A. Marston; 4.3.3 Intra-abdominal sepsis: H. van Goor and R.J.A Goris; 4.3.4 Acute acalculous cholecystitis: M.J Shapiro; 4.4 Pancreatitis; 4.4.1 Pathophysiology and diagnosis: T. Dugernier and M.S Reynaert; 4.4.2 Conservative management: T. Dugernier and P.J. Kestens; 4.4.3 Surgical management: B. Rau and H.G Beger; 4.5 Disordered gastric motility; 4.5.1 Vomiting: G.J Dobb; 4.5.2 Large nasogastric aspirates: G.J Dobb; 4.5.3 Ileus and obstruction: D.C Evans and J.C Marshall; 4.5.4 Diarrhea: G.J Dobb; 4.5.4 Constipation: G.J Dobb; 4.6 Jaundice; 4.6.1 Pathophysiology and causes: A.E.S Gimson; 4.6.2 Therapeutic strategy: A.E.S Gimson; 4.7 Acute hepatic failure; 4.7.1 Pathophysiology and causes: R. Williams; 4.7.2 Diagnosis and assessment: F. Hawker; 4.7.3 Management: J. Wendon; 4.7.4 Management of complications: F. Hawker; 4.7.5 The effect of acute hepatic failure on drug handling: T.S Leary and G.R Park; 5 Nutrition; 5.1 Normal physiology; 5.1.1 Nutrition: K.N Jeejeebhoy; 5.2 Nutritional failure; 5.2.1 The metabolic and nutritional response to critical illness: G.Lavery; 5.2.2 Pathophysiology of nutritional failure: S.M Gabe and G.K Grimble; 5.2.3 Assessing nutritional status: J.-M Boles; 5.3 Nutritional support; 5.3.1 Enteral nutrition: G.J Dobb; 5.3.2 Parenteral nutrition: G. Iapichino and D. Radrizzani; 6 The Renal system; 6.1 Normal physiology; 6.1.1 The renal system: J. Reichmann and M. Brezis; 6.2 Oliguria; 6.2.1 Diagnosis and assessment: C. Ronco and A.G Fabris; 6.2.2 Management: J.J Cordingley and M.G.A Palazzo; 6.3 Acute renal failure; 6.3.1 Pathophysiology: J. Reichmann and M. Brezis; 6.3.2 Diagnosis: R. Bellomo and C. Ronco; 6.3.3 Management: R. Bellomo and C. Ronco; 6.4 Established renal failure; 6.4.1 The effect of renal failure on drug handling: A. Olyaei and W.M Bennett; 6.4.2 The effect of chronic renal failure on critical illness: R.G Woolfson; 7 The neurological system; 7.1 Normal physiology; 7.1.1 The nervous system: M.W Nicolle and G.B Young; 7.2 The unconscious patient; 7.2.1 Pathophysiolgy: E. Oschatz and A.N Laggner; 7.2.2 Causes and diagnosis: T.P Black and A.R Webb; 7.2.3 Management: T.P Black and A.R Webb; 7.3 Seizures; 7.3.1 Pathophysiolog and causes: T.P Black; 7.3.2 Assessment: T.P Black; 7.3.3 Management: T.P Black; 7.4 Raised intracranial pressure and cerebral edema; 7.4.1 Pathophysiology and generalized cerebral edema: L.F Marshall; 7.4.2 Pathophysiology of space-occupying lesions: E.M Trinidad and T.H Milhorat; 7.4.3 Diagnosis of raised intracranial pressure: A. Mallick and N.M Dearden; 7.4.4 Management of cerebral edema: H. Klein and N.M Dearden; 7.5 Non-traumatic intracranial hemorrhage; 7.5.1 Assessment: H.M Fernandes and A.D Mendelow; 7.5.2 Medical management: M.J.G Harrison; 7.5.3 The role of surgical management: H.M Fernandes and A.D Mendelow; 7.6 Meningitis; 7.6.1 Pathophysiology and causes: M. Levin and S. Nadel; 7.6.2 Therapeutic approach: M. Levin and S. Nadel; 7.7 Encephalitis; 7.7.1 Pathophysiology and causes: R.P Paczynski and D.B Clifford; 7.7.2 Therapeutic approach: R.P Paczynski and D.B Clifford; 7.8 Acute weakness; 7.8.1 Pathophysiology and causes of neuropathy: C.F Bolton; 7.8.2 Pathophysiology and causes of myopathy: C.F Bolton; 7.8.3 Assessment: J. Coakley; 7.8.4 Management: J. Coakley; 7.8.5 Specific treatment for Guillain-Barre syndrome: D. Hunt and D.J Cook; 7.9 Acute myasthenia; 7.9.1 Pathophysiology: L. Loh; 7.9.2 Assessment: L. Loh; 7.9.3 Treatment: L. Loh; 7.9.4 Crisis in myasthenia gravis: L. Loh; 7.10 Tetanus; 7.10.1 Pathophysiology: M. Hopley and J. Lipman; 7.10.2 Prevention and management: H. Hon and J. Lipman; 7.11 Brainstem death and management of the potential; 7.11.1 The diagnosis of brainstem death: C.J Hinds; 7.11.2 Managing the potential organ donor: C.J Hinds; 7.11.3 Management of the relatives of a potential organ donor: B. Watson and V. Morgan; 7.11.4 The organ donation process: I.J.A Davidson and D.A Payne; 7.12 Sleep disturbance; 7.12.1 Pathophysiology: N.P Hirsch and R.S Howard; 7.12.2 Therapeutic strategy: N.P Hirsch and R.S Howard; 7.13 Agitation and confusion; 7.13.1 Causes: S. Heckers and T. Stern; 7.13.2 Therapeutic management: S. Heckers and T. Stern; 7.13.3 Therapeutic management: S. Heckers and T. Stern; 7.14 Pain; 7.14.1 Pathophysiology: M. Schafer and C. Stein; 7.14.2 Assessment: A.R Molloy and M.J Cousins; 7.14.3 Management: A.R Molloy and M.J Cousins; 8 The metabolic and endocrine systems; 8.1 Normal Physiology; 8.1.1 The endocrine system: D. Watson; 8.2 Electrolyte disturbance; 8.2.1 Hypernatremia: A.I Arieff; 8.2.2 Hyponatremia: A.I Arieff; 8.2.3 Hyperkalemia: J. Salmon; 8.2.4 Hypokalemia: J. Salmon; 8.2.5 Hypomagnesemia: H.G Wakeling and M.G Mythen; 8.2.6 Hypercalcemia: N.B Eastwood and M.G Mythen; 8.2.7 Hypocalcemia: T.J Gan; 8.2.8 Hyperphosphatemia: J.V Booth and M.G Mythen; 8.2.9 Hypophosphatemia: J.V Booth and M.G Mythen; 8.3 Metabolic acidosis; 8.3.1 Pathophysiology and causes: D.M Forrest and J.A Russell; 8.3.2 Therapeutic strategy: D.M Forrest and J.A Russell; 8.4 Metabolic alkalosis; 8.5 Hyperglycemia; 8.5.1 Pathophysiology: G. Bishop and K. Hillman; 8.5.2 Assessment: G. Bishop and K. Hillman; 8.5.3 Management of hyperglycemia: P. Bristow and K. Hillman; 8.5.4 Management of hyperglycemic diabetic emergencies: P. Bristow and K. Hillman; 8.6 Hypoglycemia; 8.6.1 Pathophysiology: R.B Noone and M.G Mythen; 8.6.2 Therapeutic strategy: I.C Sanderson and M.G Mythen; 8.7 Hypoadrenalism; 8.7.1 Pathophysiology: L.G Thijs; 8.7.2 Therapeutic strategy: L.G Thijs; 8.8 Hypopituitarism; 8.8.1 Pathophysiology: G. Van den Berghe; 8.8.2 Therapeutic strategy: G. Van den Berghe; 8.9 Hyperthyroidism; 8.9.1 Pathophysiology: D. Watson; 8.9.2 Therapeutic strategy: D. Watson; 8.10 Hypothyroidism; 8.10.1 Pathophysiology: S. Arlot and A. Fournier; 8.10.2 Therapeutic strategy: S. Arlot and A. Fournier; 9 Poisoning; 9.1 Principles of management; 9.1.1 Role of toxicology assessment: A. Jaeger; 9.1.2 Elimination techniques: S.W Borron and C. Bismuth; 9.2 Management of specific poisons; 9.2.1 Salicylate: J.A Henry; 9.2.2 Acetaminophen (paracetamol): A. Rhodes and J. Wendon; 9.2.3 Opiates: G. Conti and A. Gasparetto; 9.2.4 Benzodiazepines: P. Lheureux and M. Vranckx; 9.2.5 Tricyclic antidepressants: J.A Henry and M.C Colbridge; 9.2.6 Amphetamines and ecstasy: T.K Hartung and J.A Henry; 9.2.7 Digoxin: E.M Antman and T.W Smith; 9.2.8 Cocaine: M.E Palmer and L.R Goldfrank; 9.2.9 Beta-Blockers: S.W Metcalf; 9.2.10 Cyanide: D.G Penney and W.E Porter; 9.2.11 Alcohols: D. Jacobsen; 9.2.12 Carbon monoxide: S.G Simonson and C.A Piantadosi; 9.2.13 Corrosives: S.W Metcalf; 9.2.14 Pesticides and agricultural chemicals: K. Koyama; 10 The haematological system; 10.1 Normal physiology; 10.1.1 The blood cells: K.K Hampton and C.A.J Wardrop; 10.2 Disordered coagulation; 10.2.1 Pathophysiology: A.C Nathwani and S.J Machin; 10.2.2 Disseminated intravascular coagulation: D. Cummins; 10.2.3 Thrombosis: H. Cohen and C. Ozanne; 10.2.4 Thrombocytopenia: C.N Harrison and S.J Machin; 10.3 The neutropenic patient; 10.3.1 Pathophysiology: A.C Nathwani and A.H Goldstone; 10.3.2 Management of neutropenia and its consequences: A.C Nathwani and A.H Goldstone; 10.4 Anemia; 10.4.1 Pathophysiology: E.C.M van Gorp and H. ten Cate; 10.4.2 Hemolysis: J.P Isbister; 10.4.3 Blood transfusion: P. Hewitt and F. Regan; 10.5 Polycythemia; 10.5.1 Pathophysiology: C.A.J Wardrop; 10.5.2 Therapeutic strategy: C.A.J Wardrop; 10.6 Sickle crisis; 10.6.1 Pathophysiology: G.R Serjeant; 10.6.2 Prevention and management of complications: G.R Serjeant and M. Singer; 11 Trauma, burns and physical disorders; 11.1 Multiple trauma; 11.1.1 Pathophysiology of chest trauma: P.A Carli and M. Lejay; 11.1.2 Pathophysiology of abdominal trauma: J. Biert and R.J.A Goris; 11.1.3 Assessment: R.F Wilson and J.G Tyburski; 11.1.4 Management of the chest injury: J.E Mazuski and R.M Durham; 11.1.5 Management of abdominal injury: M. Poeze and G. Ramsay; 11.1.6 Rhabdomyolysis and compartment syndrome: J.-M Boles; 11.1.7 Fat embolism: J.M Ryan and S.W Metcalf; 11.1.8 Air embolis: C. O'Donnell and M. Gavalas; 11.1.9 The role of surgical managment of fractures: R.J.A Goris and J. Biert; 11.2 Ballistic trauma; 11.2.1 Pathophysiology: D.V Shatz and O.C Kirton; 11.2.2 Assessment: K.A Kralovich and H.M Horst; 11.2.3 Management: R.C Karmy-Jones and J.W Wagner; 11.3 Head injury; 11.3.1 Pathophysiology: J. Jallo and R.K Narayan; 11.3.2 Assessment: J. Jallo and R.K Narayan; 11.3.3 Medical Management: A. Main and N.M Dearden; 11.3.4 The role of surgery: R.P Boyer and J.J Oro; 11.4 Spinal injury; 11.4.1 Pathophysiology: C. Werner; 11.4.2 Management of cervical cord injury: C. Werner; 11.4.3 Management of spinal cord injury: R.S.R Fox; 11.5 Burns; 11.5.1 Pathophysiology: J. Hammond; 11.5.2 Assessment: J.B Cone and R.D Robertson; 11.5.3 Medical Management: J.B Cone and R.D Robertson; 11.5.4 Role of Surgical Management: J.R Saffle; 11.6 Drowning; 11.6.1 Pathophysiology: P.G Boysen and J.E Szalados; 11.6.2 Management: P.G Boysen and J.E Szalados; 11.7 Electrocution; 11.7.1 Pathophysiology: R.F Armstrong; 11.7.2 Management: R.F Armstrong; 11.8 Noise; 11.8.1 Pathophysiology: D. Balogh and A. Benzer; 11.8.2 Management: D. Balogh and A. Benzer; 11.9 Altitude- and depth-related critical illness; 11.9.1 Pathophysiology related to altitude: W. Schobersberger and N. Mutz; 11.9.2 Pathophysiology related to depth: W. Hasibeder and N. Mutz; 11.9.3 Management: M. Maggiorini; 11.10 Hyperthermia and pyrexia; 11.10.1 Pathophysiology of fever: D.C Macallan; 11.10.2 Assessment of fever: D.C Macallan; 11.10.3 Management of fever: D.C Macallan; 11.10.4 Pathophysiology of malignant hyperthermia: P.J Halsall and F.R Ellis; 11.10.5 Management of malignant hyperthermia: P.J Halsall and F.R Ellis; 11.10.6 Pathophysiology of heat-stroke: A.M.S Kashmeery; 11.10.7 Management of heat-stroke: C.J Ash and A.M.S Kashmeery; 11.11 Hypothermia; 11.11.1 Pathophysiology: M.-D Schaller and P. Eckert; 11.11.2 Management: M.-D Schaller and P. Eckert; 11.12 Transport of the critically ill patient; 11.12.1 Pathophysiology related to movement of the critically ill: B.J Tortella and M.J Shapiro; 11.12.2 Minimizing risk during transport: J.E Gilligan; 11.12.3 Equipment required for in-hospital transfer: S.A Ridley; 11.12.4 Equipment required for between-hospital transfer: A.G Morrison and P.G.M Wallace; 11.12.5 Personnel required for transport: A. Bristow and M.J Shapiro; 12 Obstetric problems; 12.1 Normal physiology; 12.1.1 Obstetrics: C. Nelson-Piercy and M. de Swiet; 12.2 Pre-eclampsia and eclampsia; 12.2.1 Pathophysiology: D.O.C Anumba and S.C Robson; 12.2.2 Management of pre-eclampsia: D.O.C Anumba and S.C Robson; 12.2.3 Management of eclampsia: S.C Robson; 12.3 HELLPsyndrome; 12.3.1 Pathophysiology: P.F Laterre and M.S Reynaert; 12.3.2 Therapeutic strategy: P.F Laterre and T. Dugernier; 12.4 Postpartum hemorrhage; 12.4.1 Pathophysiology and therapeutic strategy: H. El-Refaey and J. Kingdom; 12.5 Obstetric emboli; 12.5.1 Pathphysiology: T. Dugernier and M.S Reynaert; 12.5.2 Therapeutic strategy: T. Dugernier and P.F Laterre; 13 Infection and systemic inflammation; 13.1 Normal physiology; 13.1.1 Immunology: P.G Medd and B.M Chain; 13.2 Infection and control issues; 13.2.1 Hygiene: G.L Ridgway; 13.2.2 Isolation: G.L Ridgway; 13.2.3 Antimicrobial selection policies: A.P.R Wilson; 13.2.4 Selective decontamination: C.P Stoutenbeek and H.K.F van Saene; 13.3 Nosocomial infection; 13.3.1 Pathophysiology and management: P.S Barie and J.T Cooke; 13.3.2 Prevention: S. Harbarth and D. Pittet; 13.4 Infection in the immunocompromised; 13.4.1 Drug-induced depression of immunity: M. Chapman and S. Peake; 13.4.2 Immune dysfunction associated with critical illness: G.J Bellingan; 13.5 HIV-related disease; 13.5.1 Infections associated with HIV: M.G Brook and R.F Miller; 13.5.2 Role of intensive care in HIV disease: R.F Miller and M.G Brook; 13.6 Tropical diseases; 13.6.1 Malaria: C.J.M Whitty and P.L Chiodini; 13.6.2 Other tropical diseases: C.J.M Whitty and P.L Chiodini; 13.7 Multisystem involvement in shock; 13.7.1 Assessment: O. Boyd and P. Newman; 13.7.2 Therapeutic strategy: P. Newman and R.M Grounds; 13.8 Multiple organ failure; 13.8.1 Pathophysiology: J.F Bion; 13.8.2 Assessment: J.-L Vincent; 13.8.3 Therapeutic strategy: J.-L Vincent; 13.9 Anaphylaxis; 13.9.1 Pathophysiology: J.H Levy and M. Fisher; 13.9.2 Assessment and therapeutic strategy: M. Fisher; 13.10 Connective tissue disorder; 13.10.1 Systemic lupus erythematosus: U.B.S Prakash; 13.10.2 Vasculitis: U.B.S Prakash; 13.10.3 Rheumatoid arthritis: U.B.S Prakash; 14 Perioperative problems; 14.1 General postoperative intensive care; 14.1.1 Recovery from anaesthesia: D.R Miller and A.D Baxter; 14.1.2 Postoperative pain relief: A.D Baxter and D.R Miller; 14.1.3 Ventilatory function in the postoperative period: J.T Cooke and P.S Barie; 14.1.4 Postoperative fluid and circulatory management: R.M Grounds and O. Boyd; 14.2 Management of specilized surgical patients; 14.2.1 Orthopaedic surgery: M. Fennelly and G. Edge; 14.2.2 Vascular surgery: E.P Wilson and R.A White; 14.2.3 Thoracic surgery: J.A McGuigan and K. Lowry; 14.3 Postcardiac surgical intensive care; 14.4 Postneurosurgical intensive care; 14.4.1 Postoperative protection against cerebral injury: M. Smith; 14.4.2 Circulatory management: D.K Menon and A. Swami; 14.4.3 Ventilatory management: M. Smith; 14.5 Post-transplantation surgery; 14.5.1 Renal transplantation: I.J.A Davidson and M. Ulrich; 14.5.2 Cardiac transplantation: G.D Matrich and B.P Griffith; 14.5.3 Hepatic transplantation: M. Manji and J.F Bion; 14.5.4 Lung transplantation: R. Ruggiero and C.A Keller; 15 Management of the critical care department; 15.1 The intensive care department; 15.1.1 Design of the department: T.E Oh; 15.1.2 Site, size and interactions with other departments: D.C Jerwood and E. Major; 15.1.3 Staffing of the department: D. Reis Miranda and L.J. Broerse; 15.1.4 Patient safety: S.J.Y Bard and G.R Park; 15.1.5 Staff safety: P.J Cole and G.R Park; 15.1.6 Staff welfare: P.J Cole and G.R Park; 15.1.7 Fire and electrical safety: J.E Risdall and G.R Park; 15.1.8 The role of intensive care unit policies: B. Morgan and W.J Sibbald; 15.1.9 Resource management: M. Jegers and D. Reis Miranda; 15.2 Medicolegal and ethical issues; 15.2.1 Consent/assent to treatment: S.A.M McLean; 15.2.2 Medical research: S.L Cohen; 15.2.3 Withdrawing treatment: R. Ritz and G. Stratenwerth; 15.2.4 Law enforcement issues: C.P.H Heneghan; 15.2.5 The role of the coroner in the United Kingdom: M.A Branthwaite; 15.2.6 Key differences between the role of the coroner in the United States and the United Kingdom: M. Graham; 15.2.7 Clinical liability: C.P.H Heneghan; 15.3 Scoring systems in intensive care; 15.3.1 The role and limitations of scoring systems: K. Rowan; 15.3.2 Principles of severity scoring: K. Rowan; 15.3.3 Acute Physiolohy and Chronic Health Evaluation (APACHE): J.E Zimmerman and W.A Knaus; 15.3.4 Simplified Acute Physiology Score (SAPS): J.-R Le Gall; 15.3.5 Therapeutic Intervention Scoring System (TISS): D.J Cullen; 15.3.6 Mortality Probability Model (MPM): A.D Collins and S. Lemeshow; 15.3.7 Trauma scoring: H.R Champion and W.J Sacco; 15.3.8 Glasgow Coma Scale: J.E Zimmerman and W.E Knaus; 15.3.9 Sedation scoring: A. Hole and P. Klepstad; 15.3.10 Organ failure scoring: J.C Marshall; 16 Monitoring equipment and techniques; 16.1 Cardiorespiratory monitoring; 16.1.1 ECG monitoring: W.R Lewis and E.S Kaufman; 16.1.2 Pulse oximetry: J.A Pologe; 16.1.3 Blood pressure monitoring: R.M. Gardner; 16.1.4 Central venous catheterization: J.L Peters and R. Moore; 16.1.5 Pulmonary artery catheterization: A.B.J Groeneveld; 16.1.6 Mixed venous saturation monitoring: D. Rosser; 16.1.7 Cardiac output assessment: H.E Montgomery and M. Singer; 16.1.8 Oxygen transport: J.D Edwards; 16.1.9 Right ventricular function: H.E Montgomery; 16.1.10 Measurement of extravascular lung water: P. Frost and D. Bihari; 16.1.11 Gastrointestinal tonometry: G. Gutierrez; 16.2 Blood gases; 16.2.1 Blood gas analyzers: B.A Shapiro; 16.2.2 Blood gas analysis: B.A Shapiro; 16.3 Ventilatory monitoring; 16.3.1 Capnography: L. Blanch and A. Artigas; 16.3.2 Flow-volume and pressure-volume loops: J.C Goldstone; 16.3.3 Monitoring gas exchange and ventilation-perfusion matching: R. Rodriguez-Roisin and J. Roca; 16.3.4 Respiratory muscle function: M. Aubier; 16.3.5 Respiratory system compliance and resistance: J.C Goldstone; 16.4 Imaging; 16.4.1 Imaging the respiratory system: J.A Worrell; 16.4.2 Imaging the cardiovascular system: G. Porenta and G. Maurer; 16.4.3 Doppler echocardiography in intensive care: J.L Fellahi and F. Jardin; 16.4.4 Imaging the upper urinary tract: U. Patel and M.J Kellett; 16.4.5 Imaging the central nervous system: J.M Stevens and C. Mandel; 16.5 Laboratory monitoring; 16.5.1 Biochemical monitoring: D.C Borgstrom and J.A Weigelt; 16.5.2 Lactate: J.-L Vincent; 16.5.3 Colloid osmotic pressure: A.R Webb; 16.5.4 Hematological blood count: I. Cavill and C.A.J Wardrop; 16.5.5 Coagulation monitoring: E.C.M van Gorp and H. ten Cate; 16.5.6 Microbiological monitoring: M.R Jacobs; 16.5.7 Suptum sampling and bronchoalveolar lavage: G.J Bellingan; 16.6 Neurological monitoring; 16.6.1 Electroencephalogram monitoring: N.J Smith; 16.6.2 Intracranial pressure monitoring: R.S Graham and J.D Ward; 16.6.3 Jugular venous bulb monitoring: K. Ahmed and N.M Dearden; 16.6.4 Cerebral blood flow monitoring: P.J.D Andrews and W. Fitch; 16.7 Nutritional monitoring; 16.7.1 Indirect calorimetry: P.G Gauger and R.H Bartlett; 16.8 Specific organ function; 16.8.1 Hepatic function: A. Rhodes and J. Wendon; 16.8.2 Renal function: P.M.J.M de Vries; 17 Pharmaco-therapeutics; 17.1 Drugs in critical illness; 17.1.1 Analgesics: M. Tryba; 17.1.2 Antiarrhythmics: A.K.B Slade and A.J Camm; 17.1.3 Anticoagulants: A.R Webb; 17.1.4 Antidepressants: S. Heckers and T. Stern; 17.1.5 Antidiarrheals; G.J Dobb; 17.1.6 Antiseizure agents: T.P Black; 17.1.7 Antifibrinolytics: S.J Machin; 17.1.8 Antimicrobials: A.P.R Wilson; 17.1.9 Antispasmodics, antiemetics, and drugs enhancing motility: J.J Cordingley and M.G.A Palazzo; 17.1.10 Antithrombotic agents: J.P Isbister; 17.1.11 Aprotinin: A.R Webb; 17.1.12 Blood product therapy: R. Leisner; 17.1.13 Blood substitutes: O.P Habler and K. Messmer; 17.1.14 Bronchodilators: S.W Benham and C.S Garrard; 17.1.15 Diuretics: J.-A Romand; 17.1.16 Fluids: A.R Webb; 17.1.17 Immunotherapy: S. Peake and M.M Fisher; 17.1.18 Inhalational anesthetic agents: E.M Spencer and S.M Willatts; 17.1.19 Inotropic agents: R.N Sladen; 17.1.20 Muscle relaxants: B.J Pollard; 17.1.21 Nitric oxide: A. Mebazaa and D.M Payen; 17.1.22 Oxygen: R.M Jackson; 17.1.23 Prostanoids: A. Brinkmann and P.L Radermacher; 17.1.24 Respiratory stimulants: A.A Jeffrey; 17.1.25 Sedatives: W. Strobel and R. Ritz; 17.1.26 Stress ulcer prophylaxis and antiulcer drugs: D.J Cook; 17.1.27 Surfactant: W. Seeger and A. Gunther; 17.1.28 Vasoconstrictors: J.-A Vincent; 17.1.29 Vasodilator: A.B.J Groeneveld; 18 Therapeutic equipment and techniques; 18.1 Airway access; 18.1.1 Physiology of the intubated airway: G. Hedenstierna; 18.1.2 Preparing the patient for endotracheal intubation: R. Whitta; 18.1.3 Selection of tube and route: R. Whitta; 18.1.4 Techniques of tracheal intubation: R. Whitta; 18.1.5 The difficult intubation: M.E Faymonville and M.Lamy; 18.1.6 Minitracheostomy: D.W Ryan; 18.1.7 Tracheostomy: P.B Hazard; 18.2 Ventilatory support; 18.2.1 Physiology of positive-pressure ventilation: J.C Goldstone; 18.2.2 Continuous positive airways pressure: J.-A Romand and P.M Suter; 18.2.3 Non-invasive positive-pressure ventilation: G.U Meduri; 18.2.4 Indications for mechanical ventilation: R.F Armstrong; 18.2.5 Design and function of mechanical ventilators: R.A Smith; 18.2.6 Respiratory rate: G.J Wrathall; 18.2.7 Tidal and minute volume: G.J Wrathall; 18.2.8 Inspiratory time: G.J Wrathall; 18.2.9 Positive end-expiratory pressure: P.M Suter; 18.2.10 Volume-controlled mechanical ventilation: J.J Marini; 18.2.11 Pressure-controlled mechanical ventilation: S.E Lapinsky and A.S Slutsky; 18.2.12 Pressure support ventilation: J. Mancebo and L. Brochard; 18.2.13 Effects of mechanical ventilation on the circulation: M.R Pinsky; 18.2.14 Effects of mechanical ventilation on other organ function: M. Hemmer; 18.2.15 Ventilator trauma: J.J Marini; 18.2.16 High-frequency ventilation: B.F Keogh and E.H Gluck; 18.2.17 External high-frequency oscillation: M. Nevin; 18.2.18 Other novel modes of ventilation: J. Mancebo and V.M Ranieri; 18.3 Extracorporeal and non-ventilatory support; 18.3.1 Physiology of failure of mechanical ventilation to support gas exchange: K.P Kelly and R. Rossaint; 18.3.2 Extracorporeal respiratory support: L. Gattinoni and L. Brazzi; 18.4 Cardiovascular system; 18.4.1 Defibrillation: R.F Armstrong and G.Maughan; 18.4.2 Pacing and the intensive care unit: H.E Montgomery; 18.4.3 Intra-aortic balloon counterpulsation: P. Kallis; 18.4.4 Sengstaken tube: J. Wendon; 18.5 Renal replacement therapy; 18.5.1 Continuous hemofiltration techniques: M. Schetz; 18.5.2 Hemodialysis: M. Schetz; 18.5.3 Peritoneal dialysis: F.D Thompson; 18.5.4 Plasmapheresis: L.Y Vitou and M. Sternbach