Preface

We present Lange Critical Care in the spirit of our philosophy that the distinctions between critical care medicine, critical care surgery, and critical care anesthesiology are artificial; more the result of politics than medicine. All intensivists, regardless of primary discipline, must possess a core set of critical care skills that allow them to manage the sickest of patients. Surgical, medical, anesthesia, or neurological problems can arise in any patient, particularly in the critically ill. Furthermore, most hospitals today contain intensive care units (ICUs) that are mixed by intention or by overflow and multidisciplinary trained intensivists are best equipped to both recognize and manage the wide range of acute care problems.

The chapters reflect the growing scope of critical care provided outside of the ICU and the increasing importance and recognition of critical care services within the hospital structure. The Pre-ICU Critical Care section focuses on triage, transport, resuscitation, and stabilization, and includes forward-looking chapters on pre-ICU syndromes, hypothermia, military-related injuries, regionalization of critical care, and biomarkers in decision making. The second and largest section, ICU Critical Care, contains over 74 chapters and subchapters on multidisciplinary critical care that includes comprehensive coverage of medical, surgical, anesthetic, and neurological issues involving multiple organ systems. The third section, Management, includes chapters on education and simulation, bed utilization, the ICU’s role in the global hospital environment, ICU staffing models, telemedicine issues, ethics, palliative care, and ICU governance. The fourth section, Post-ICU Critical Care, contains chapters on postintensive care syndrome and outcomes research. The fifth section, Genomics of Critical Care, contains one chapter, Critical Care Medicine in the Era of Omics, written to provide a basic understanding of the potential applications of genomics unique to tackling critical illnesses. An integral part of critical care practice is addressed in the sixth section, Critical Care Procedures, that includes guidance in maintaining patient safety and extracting accurate information from monitors. The seventh section, Appendices, contains reference material and formulas, including a chapter on bedside statistics, an essential skillset for the modern intensivist. Sprinkled throughout each section are “Controversies” chapters provided to address some of the more ambiguous aspects of critical care.

In keeping with the team approach and multiprofessional nature of critical care delivery, several chapters are authored or coauthored with critical care fellows, ICU nurses, physician assistants, nurse practitioners, and pharmacists.

In addition to practicing critical care physicians and fellows in training, this edition is designed to be a valuable resource for all critical care providers-hospitalists, subspecialty physicians, residents, nurses, physician assistants, nurse practitioners, nutritionists, pharmacists, respiratory therapists, and medical students.

We are grateful to the publishing editors at McGraw-Hill (Brian Belval, Christie Naglieri, and Kathryn Schell) for their tireless efforts and guidance in the production of this textbook.