Progress in the field of medicine over the last 50 years has led to important results for society, both in terms of prevention and in the treatment of single or variously associated pathologies. The main objective of modern medicine has been the acquisition of increased skills and highly specialised knowledge in the various disciplines. At the same time, there has been a progressive multidisciplinary and multi-professional interest in acute disease conditions that place the patient in potential or real life-threatening situations. The state of the art of intensive medicine comprises a wide range of sophisticated interventions and collaboration between different medical disciplines, both of which give the patient access to the most advanced forms of treatment that are currently available.

Although this volume presents plenty of topics in constant evolution, as witnessed by the collection of chapters compiled by several researchers, this edition includes, in particular, fields in which decision making at the patient’s bedside prevails over theoretical argumentation. In other words, the first and foremost message this edition wants to provide is for the reader to focus his/her attention on evidence-based medicine.

At the APICE '96 research scientists and clinicians were provided with updated guidelines for the treatment of patients with acute and chronic critical conditions. This volume contains 100 chapters,in which the main pathophysiological concepts were reviewed, with special emphasis on the cardiovascular, respiratory, metabolic, and neurologic systems. Special reference is made to the pharmacologic and biotechnologic strategies currently being used to support those vital functions that are affected by severe and sometimes devastating diseases. The topics of infection, sepsis,and SIRS have been reviewed and updated in keeping with the most recent information available, and particular focus has been directed to ethics.

The management of the critically ill patients has been in the past few years a discipline at the forefront of development which continues to make progress with the support of basic and clinical research. This work is a collection of material that deals with the management of critically ill patients, published on the occasion of the 13th APICE congress in November 1998, which celebrated 40 years of Critical Care Medicine.

The end of the second millenium is distinguished for the increasing interest in the field of critical care medicine, not only among physicians and clinical scientists but also on the part of the mass media. This is an interdisciplinary area of medicine drawing upon the specialties of anesthesiology, internal medicine and surgery, and relying upon the essential contributions and support from basic research. Advances in critical care medicine depend on the application of new technologies to the clinic, the full integration of computers and informatics, the continual training of physicians and technicians, and the consideration of ethical issues in the clinical setting. Within this complex panorama of complementary approaches and viewpoints, it is apparent that critical care medicine is one of the best examples of evidence-based medicine.

Continuous update in critical care medicine is a real challenge due to the growing dimensions of its contents; these elements are the result of new research acquisitions, and of those clinical situations where the physician is able to intervene at a given moment, with the use of effective prevention techniques. They are also the result of new technologies able to define complex sub-clinical diagnostic aspects; lastly, they are the result of effective therapeutic techniques available, and of treatment strategies able to influence radically and positively the patient's clinical course. Critical care medicine is playing a key role in the most advanced environments, as it represents a cross-sectional field of action, involving several specialties, such as anesthesiology, general medicine, surgery, pediatrics.

In modern medicine the most functional methodologies are taking an increasing importance in spreading informations, rendering it credible while at the same time using reliable data to focus interaction between basic science and clinical medicine. Critical care medicine embraces these needs and more than any other discipline thrives and develops thanks to interdisciplinary contact. APICE 2004 has been organised to provide precise answers to these issues. In particular, considerable emphasis has been given to the reviews regarding the most important aspects - or the most significant clinical developments - in the sectors involving variety of functions: neurological, respiratory and cardiovascular, gastrointestinal, metabolism and perfusion; trauma infections, sepsis and organ failure; perioperative medicine and life support techniques; information technology dedicated to clinical medicine, but also as a means of information and education. The contributing authors are all part of leading research groups at the international level in the various sectors presented in the volume.

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.

Basic research, progress in technology and informatics, and the success of clinical pharmacology are the fundamental bases of this interesting field of medicine. Nowadays, critical care medicine is no longer for experts only, but it is a field in which researchers and clinicians, nurses and technical staff work in an interdisciplinary way, each offering their own skills. The volume is divided in six sections, devoted to critical care key issues, to lung diseases, to trauma, to acid-base equilibrium, to perioperative medicine, and to obstetrics.