TY - CHAP M1 - Book, Section TI - Preface A1 - Hall, Jesse B. A1 - Schmidt, Gregory A. A1 - Kress, John P. PY - 2015 T2 - Principles of Critical Care, 4e AB - Few fields in medicine have blossomed as dramatically as critical care. When we published the first edition of Principles of Critical Care in 1992, the critically ill were treated based largely on knowledge of pathophysiology, often derived from whole animal models. The evidence base for treatment was sparse and, with few exceptions, large, well-conducted clinical trials were lacking. What a change the past two decades have brought! The nature of critical illness is far better understood at molecular, cellular, organ, whole patient, and population levels. Diagnostic and monitoring tools, such as point-of-care ultrasound, stroke volume estimating equipment, and biomarkers, have altered the way we examine our patients. New drugs and devices have been devised, tested, and applied. Large clinical trials now inform a broad range of treatments, including those for respiratory failure, septic shock, acute kidney injury, raised intracranial pressure, and anemia of critical illness. Protocols and bundles aid, and sometimes frustrate, our provision of care. The modern intensivist must both master a complex science of pathophysiology and be intimately familiar with an increasingly specialized literature. No longer can critical care be considered the cobbling together of cardiology, nephrology, trauma surgery, gastroenterology, and other organ-based fields of medicine. In the 21st century, the specialty of critical care has truly come of age. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=1107710334 ER -