Page 24 - Hall et al (2015) Principles of Critical Care-McGraw-Hill

Preface

Few fields in medicine have blossomed as dramatically as critical care. Our approach to patient care, teaching, and investigation of critical
When we published the first edition of Principles of Critical Care in 1992, care is energized fundamentally by our clinical practice. In turn, our
the critically ill were treated based largely on knowledge of pathophysi- practice is informed, animated, and balanced by the information and
ology, often derived from whole animal models. The evidence base for environment arising around learning and research. Clinical excellence is
treatment was sparse and, with few exceptions, large, well-conducted founded in careful history taking, physical examination, and laboratory
clinical trials were lacking. What a change the past two decades have testing. These data serve to raise questions concerning the mechanisms
brought! The nature of critical illness is far better understood at molecu- for the patient’s disease, upon which a complete, prioritized differen-
lar, cellular, organ, whole patient, and population levels. Diagnostic tial diagnosis is formulated and treatment plan initiated. The reality,
and monitoring tools, such as point-of-care ultrasound, stroke volume complexity, and limitations apparent in the ICU drive our search for
estimating equipment, and biomarkers, have altered the way we exam- better understanding of the pathophysiology of critical care and new,
ine our patients. New drugs and devices have been devised, tested, and effective therapies. It is our hope that this textbook is a reflection of the
applied. Large clinical trials now inform a broad range of treatments, interweaving and mutually supporting threads of critical care practice,
including those for respiratory failure, septic shock, acute kidney injury, teaching, and research.
raised intracranial pressure, and anemia of critical illness. Protocols and In addition to our author-contributors, we are indebted to our own
bundles aid, and sometimes frustrate, our provision of care. The modern students of critical care at the University of Chicago and the University
intensivist must both master a complex science of pathophysiology and of Iowa who motivate our teaching—our critical care fellows; residents
be intimately familiar with an increasingly specialized literature. No lon- in anesthesia, medicine, neurology, obstetrics and gynecology, pediat-
ger can critical care be considered the cobbling together of cardiology, rics, and surgery; and the medical students at the Pritzker School of
nephrology, trauma surgery, gastroenterology, and other organ-based Medicine and the Carver College of Medicine. It has also been a source
fields of medicine. In the 21st century, the specialty of critical care has of knowledge and inspiration to interact with practicing physicians
truly come of age. from around the world in many courses and symposia, helping us to
Why have a textbook at all in the modern era? Whether at home, in understand the breadth of critical care as it is practiced and continues
the office, or on the road, we can access electronically our patients’ vital to evolve. All of these colleagues make our practice of interdisciplinary
signs, radiographs, and test results; at the click of a mouse, we can peruse critical care at the University of Chicago and the University of Iowa
the literature of the world; consulting experts beyond our own institu- interesting and exciting.
tions is facilitated through email, listserves, and Web-based discussion While the field of critical care has changed greatly since the last edition
groups. To guarantee that this text remains useful in its electronic and of our textbook, so has the core of senior authors. Thirty years ago, Larry
print versions, we have challenged our expert contributors to deal with Wood inspired Jesse Hall and Greg Schmidt to join him in the pursuit of
controversy, yet provide explicit guidance to our readers. Experts can excellence in the practice, teaching, and study of critical care medicine,
evaluate new information in the context of their reason and experience and they have remained steadfast in their appreciation of his mentorship
to develop balanced recommendations for the general intensivist who along this path. More than 20 years ago, Larry invited these colleagues
may have neither the time nor inclination to do it all himself/herself. to join him in the creation of the first edition of this textbook, a project
A definitive text should both explicate the common mechanisms that that has remained a valued task by us all as the reputation of the text has
transcend all critical illness and provide an in-depth, specific discus- grown and it has mapped the course of a dynamically changing field.
sion of important procedures and diseases. The exceptional response Several years ago, Larry retired and chose to end his participation in
to the first three editions of Principles of Critical Care showed us that this project. While we miss his sage advice, keen insight, and mastery of
we have succeeded. In this fourth edition, we have added new chapters critical care, we believe he feels this project is in good hands, because he
on ICU Ultrasound, Extracorporeal Membrane Oxygenation, ICU- trained us well and we have now been joined by John Kress, professor of
Acquired Weakness, Abdominal Compartment Syndrome, and Judging medicine, anesthesia, and critical care at the University of Chicago. John
the Adequacy of Intravascular Volume, among others. The changing is another trainee of Larry’s, and a much valued colleague ever since his
nature of modern critical care spawned new or completely revised residency and fellowship training with us. John has moved seamlessly
chapters regarding Preventive Bundles, Informatics, Statistics, Rapid into a role as associate editor and without his help this endeavor would
Response Teams, Physical Therapy, and more. In addition, we recognize surely have been impossible. We look forward to his engagement in
that critical illness stresses entire systems, not just individual patients, so future editions. Even with all this help, we could not have completed the
we have created new contributions on caregiver and family issues and on organization and editing of this book without the combined efforts of
the implications of disordered sleep for the critically ill. many at McGraw-Hill. Our editors have guided this group of academic
We have collected up front many of the issues of organization that physicians through the world of publishing to bring our skills and ideas
provide the foundation for excellent critical care as well as topics to a wide audience, and we are thankful for their collaboration. We also
germane to almost any critically ill patient. The remainder of the appreciate the consistent organizational efforts of our editorial assistant,
text follows an organ system orientation for in-depth, up-to-date Deborah Hunter, who coordinated the many responsibilities that under-
descriptions of the unique presentation, differential diagnosis, and lie such a mammoth undertaking. Her perseverance, sense of purpose,
management of specific critical illnesses. While we have made many and sunny optimism made our task much easier.
changes, we have preserved the strengths of the first three editions: a
solid grounding in pathophysiology, appropriate skepticism based in Jesse B. Hall, MD
scholarly review of the literature, and user-friendly chapters begin- Gregory A. Schmidt, MD
ning with “Key Points.” John P. Kress, MD

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