Surgical Critical Care PDF

Preface

Despite the advances in critical care in the years that have passed since the first edition of this book, achieving unambiguous diagnosis, clearly appropriate interventions, and improved patient outcomes remains elusive. The ability to acquire only static, low-dimensional, sparse data about dynamic, high-dimensional information-dense problems present constant challenges. We long for accuracy; instead we receive information with significant error. We recognize our limited understanding of critical illness, yet we cannot avoid intervening on our patients' behalf. In response to these conflicts, our goals in this second edition are the same as those of the first edition: to provide a foundation for understanding current ideas about the presentation and mechanism of the altered physiology and metabolism seen in the critically ill patient, to offer approaches to problems that are frequently encountered, and to suggest an approach when consensus about a clinical problem does not exist. The organization of this edition is similar to that of the first edition. Part I emphasizes the altered metabolism seen in the critically ill patient. Part II considers preoperative, intraoperative, and postoperative care of the critically ill patient. Part III discusses pathophysiologic conditions by organ system. Systemic pathophysiology receives emphasis in Part IV. Common procedures in the SICU are presented in Part V. Finally, measurement and interpretation of quantified data are discussed in Part VI. An introduction to the recognition, understanding and reduction of uncertainty in critical care data is provided in Part VII.

Again we are indebted to all of the contributors. We deeply appreciate their hard work, in a more difficult environment, in providing expert discussions of the problems we face daily.