Oxford Handbook of Critical Care 3rd Edition PDF

Oxford Handbook of Critical Care 3rd Edition PDF



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Preface

This new edition embraces the many recent developments occurring in critical care medicine, in particular the burgeoning number of randomised, multicentre trials and the increasing understanding of underlying basic science mechanisms. While not necessarily providing definitive answers, these studies have contributed significantly to our knowledge base and highlighted both the complexity of critical illness and the variation in individual response. They frequently demonstrate the need to recognise and treat deterioration promptly, and flag up the many detrimental effects of our current therapies and strategies. A balance needs to be sought between under- and over-treatment—be it for fluids, sedatives, antibiotics, pressors, ventilation, etc., and we will no doubt continue to refine this further in coming years, particularly with enhancements in monitoring and diagnostics.
These studies further demonstrate the ‘one size fits all’ paradigm on which traditional categorisation of patients is based, e.g. those with sepsis is, perhaps, overly simplistic. We should follow local, national, and international guidelines on patient management, yet still retain the flexibility of thought and action to diverge should an individual patient not follow the rules. We have thus provided a framework upon which a reasonable and rational practice can be based; this is clearly not the final word. We expect both healthy debate and continuing evolution!


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