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This critical care medicine book substantially differs from others due to the range of peculiarities that characterize it. Since it deals with acute patients in critical conditions, this is, as it were, a 'borderline'book,in the sense that it is intended for those, who, in their activity, need a continuous and in-depth interdisciplinary approach to optimize the quality of the treatments offered to critically-ill patients. This book helps to have a better understanding of the current limits of human intervention and aims at supplying updated guidelines; in particular, it is intended for those who, although having to guarantee continuity and top-quality therapies, must decide when and why the collaboration with and intervention by experts is necessary.
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Springer Berlin Heidelberg New York Barcelona Budapest Hong Kong London Milano Paris Tokyo A. Gullo (Ed.) Anaesthesia, Pain, Intensive Care and Emergency Medicine - A.P.I.C.E. Proceedings of the 10th Postgraduate Course in Critical Care Medicine Trieste, Italy - November 13-19, 1995 Springer Prof. ANTONINO GULLO, M.D. Head, Department of Anaesthesiology and Intensive Care Trieste University School of Medicine Trieste, Italy ISBN-13: 978-3-540-75014-7 e-ISBN-13: 978-88-470-2203-4 DOl: 10.1007/978-88-470-2203-4 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplications of this publication or parts thereof is permitted only under the provisions of the German Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law. © Springer-Verlag Italia, Milano 1996 The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific 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. Table of C~)Dtents BASICS OF CRITICAL CARE MEDICINE ANAESTHESIA Why Are Hypertensive Patients at Risk in the Perioperative Period? J.J. LEHOT, C. GIRARD, S. FILLEY, M. GEORGE, AND O. BASTIEN ................................................ 31 PAIN Acute Pain Modulation in the Central Nervous System: A Chronological Review M. TIENGO, AND C. BENEDETTI .................................................................................................... 43 HOMEOSTASIS Lactic Acidosis: Diagnosis and Treatment J.-L. VINCENT............................................................................................................................... 59 METABOLISM Immunonutrition - A New Aspect in the Treatment of Critically III Patients S. BENGMARK, AND L. GIANOTTI.................................................................................................. 73 PHARMACOLOGY Pharmacological Interactions in the Perioperative Period V.A. PEDUTO, AND R. D'UVA ...........................................................................................1.......... 93 INJURY AND TISSUE DAMAGE Cellular and Humoral Markers of Tissue Damage w. URACZ, AND R.J. GRYGLEWSKI .••.••.•..•..•.••••.••.•.••••.•••••••.•.••.••.................................................. 109 Role of