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Advances in intensive and critical care medicine occur rapidly. Innovation, training and research are the pillars that support a process deriving from basic science and multiprofessional/multidisciplinary interventions. This volume highlights several innovations for optimising prevention and management measures for the critically ill by integrating diagnostic procedures with pharmacological and technological options. Considering that cerebral, respiratory, cardiovascular, renal and metabolic dysfunctions occurring during serious illnesses or syndromes represent risk factors for patient survival, the final goal remains multifaceted: to improve standards and quality of care; to introduce the expanding concept of clinical governance and professionalism; to focus on the importance of ethical principles for establishing a process of patient-centred and evidence-based care. For these reasons, medical professionals must reach a consensus regarding the importance of continuing medical education.
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APICE 23 Antonino Gullo (Ed.) Anaesthesia, Pharmacology, Intensive Care and Emergency Medicine A.P.I.C.E. Proceedings of the 23rd Postgraduate Course in Critical Care Medicine Catania, Italy - November 5 - 7, 2010 Editor Antonino Gullo Department and School of Anaesthesia and Intensive Care, Catania University-Hospital Catania, Italy ISBN 978-88-470-2013-9 DOI 10.1007/978-88-470-2014-6 e-ISBN 978-88-470-2014-6 Springer Milan Dordrecht Heidelberg London New York Library of Congress Control Number: 2011923540 © Springer-Verlag Italia 2011 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, speci cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on micro lm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the Italian Copyright Law in its current version, and permission for use must always be obtained from Springer. Violations are liable to prosecution under the Italian Copyright Law. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a speci c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. 987654321 Cover design: Simona Colombo, Milan, Italy Typesetting: Graphostudio, Milan, Italy Springer-Verlag Italia S.r.l. – Via Decembrio 28 – I-20137 Milan Springer is a part of Springer Science+Business Media (www.springer.com) Contents Part I 1 Can I Think what I Read? ................................................................................ Philip D. Lumb Part II 2 1 Clinical Pharmacology Pharmacological Manipulation in ICU ........................................................... Daniel De Backer, Katia Donadello and Sabino Scolletta 9 2.1 Effects of Fluids ..................................................................................... 2.2 Effects of Red Blood Cell Transfusions ................................................. 2.3 Effects of Inotropic Agents ..................................................................... 2.4 Effects of Vasopressor Agents ................................................................ 2.5 A Place for Vasodilatory Agents? ........................................................... 2.6 Effects of Agents with Anticoagulant Properties..........