This book represents a collection of paper from different specialists involved in the management of septic patients, aimed to disseminate the knowledge in the field of sepsis, particularly to non-intensivists physicians.

This book is open access under a CC BY 4.0 license. It constitutes a unique source of knowledge and guidance for all healthcare workers who care for patients with sepsis and septic shock in resource-limited settings. More than eighty percent of the worldwide deaths related to sepsis occur in resource-limited settings in low and middle-income countries. Current international sepsis guidelines cannot be implemented without adaptations towards these settings, mainly because of the difference in local resources and a different spectrum of infectious diseases causing sepsis. This prompted members of the Global Intensive Care working group of the European Society of Intensive Care Medicine (ESICM) and the Mahidol-Oxford Tropical Medicine Research Unit (MORU, Bangkok, Thailand) - among which the Editors – to develop with an international group of experts a comprehensive set of recommendations for the management of sepsis in resource-limited settings. Recommendations are based on both current scientific evidence and clinical experience of clinicians working in resource-limited settings. The book includes an overview chapter outlining the current challenges and future directions of sepsis management as well as general recommendations on the structure and organization of intensive care services in resource-limited settings. Specific recommendations on the recognition and management of patients with sepsis and septic shock in these settings are grouped into seven chapters. The book provides evidence-based practical guidance for doctors in low and middle income countries treating patients with sepsis, and highlights areas for further research and discussion.

This book is unique in approaching multiple organ dysfunction syndrome (MODS) from the perspective of its pathophysiological mechanism, and addressing aspects that are overlooked in most of the available literature. Eminent experts in the field from Europe and beyond offer new insights into risk stratification, severity assessment, and management of critically ill patients with sepsis. The principal focus is on recently developed concepts in infection management and in antibiotic use, bearing in mind that in these patients the pharmacokinetics of antibiotics are altered, affecting renal clearance and requiring dosage adjustments. The significance of the PIRO (predisposing factors, infection, response, organ dysfunction) model in the development of effective treatment strategies is emphasized. This book will be of interest and value to all who are involved in the treatment of, or research into, sepsis and MODS.

This practically oriented book provides an up-to-date overview of all significant aspects of the pathogenesis of sepsis and its management, including within the intensive care unit. Readers will find information on the involvement of the coagulation and endocrine systems during sepsis and on the use of biomarkers to diagnose sepsis and allow early intervention. International clinical practice guidelines for the management of sepsis are presented, and individual chapters focus on aspects such as fluid resuscitation, vasopressor therapy, response to multiorgan failure, antimicrobial therapy, and adjunctive immunotherapy. The closing section looks forward to the coming decade, discussing novel trial designs, sepsis in low- and middle-income countries, and emerging management approaches. The book is internatio nal in scope, with contributions from leading experts worldwide. It will be of value to residents and professionals/practitioners in the fields of infectious diseases and internal medicine, as well as to GPs and medical students.

This book, part of the European Society of Intensive Care Medicine textbook series, teaches readers how to use hemodynamic monitoring, an essential skill for today’s intensivists. It offers a valuable guide for beginners, as well as for experienced intensivists who want to hone their skills, helping both groups detect an inadequacy of perfusion and make the right choices to achieve the main goal of hemodynamic monitoring in the critically ill, i.e., to correctly assess the cardiovascular system and its response to tissue oxygen demands. The book is divided into distinguished sections: from physiology to pathophysiology; clinical assessment and measurements; and clinical practice achievements including techniques, the basic goals in clinical practice as well as the more appropriate hemodynamic therapy to be applied in different conditions. All chapters use a learning-oriented style, with practical examples, key points and take home messages, helping readers quickly absorb the content and, at the same time, apply what they have learned in the clinical setting. The European Society of Intensive Care Medicine has developed the Lessons from the ICU series with the vision of providing focused and state-of-the-art overviews of central topics in Intensive Care and optimal resources for clinicians working in Intensive Care.

This book provides teaching scripts for medical educators in internal medicine and coaches them in creating their own teaching scripts. Every year, thousands of attending internists are asked to train the next generation of physicians to master a growing body of knowledge. Formal teaching time has become increasingly limited due to rising clinical workload, medical documentation requirements, duty hour restrictions, and other time pressures. In addition, today’s physicians-in-training expect teaching sessions that deliver focused, evidence-based content that is integrated into clinical workflow. In keeping with both time pressures and trainee expectations, academic internists must be prepared to effectively and efficiently teach important diagnostic and management concepts. A teaching script is a methodical and structured plan that aids in effective teaching. The teaching scripts in this book anticipate learners’ misconceptions, highlight a limited number of teaching points, provide evidence to support the teaching points, use strategies to engage the learners, and provide a cognitive scaffold for teaching the topic that the teacher can refine over time. All divisions of internal medicine (e.g. cardiology, rheumatology, and gastroenterology) are covered and a section on undifferentiated symptom-based presentations (e.g. fatigue, fever, and unintentional weight loss) is included. This book provides well-constructed teaching scripts for commonly encountered clinical scenarios, is authored by experienced academic internists and allows the reader to either implement them directly or modify them for their own use. Each teaching script is designed to be taught in 10-15 minutes, but can be easily adjusted by the reader for longer or shorter talks. Teaching Scripts in Internal Medicine is an ideal tool for internal medicine attending physicians and trainees, as well as physician’s assistants, nurse practitioners, and all others who teach and learn internal medicine.

This book is designed to provide a comprehensive and state-of-the-art resource for clinicians who care for patients with sepsis and research scientist alike, . Patients with severe sepsis requiring ICU admission have very high rates of ICU and overall hospital mortality, with estimates ranging from 18 to 50%. Risk factors for death from sepsis include underlying illness, increased age, and multi-system organ failure. This is compounded by the significant variation in the management of early severe sepsis. Care of these patients and clinical conditions can be quite complex, and materials are collected from the most current, evidence-based resources. Book sections have been structured to review the overall definitions and epidemiology of sepsis as well as current insights into the pathophysiology of sepsis. This review summarizes the evidence for the international consensus guidelines for the identification and management of sepsis. The latter part of this book reviews emerging concepts and approaches in the diagnosis and management of sepsis that may significantly reduce mortality in the future. Sepsis: Pathophysiology, Definitions and the Challenge of Bedside Management represents a collaboration between authors drawn from a variety of disciplines and contributions from basic scientists and highly recognized clinical opinion leaders with expertise in clinical trials.​

This textbook is written at the dawn of a new era in the management of sepsis. Recent achievements in the clinical management of septic shock are the culmination of decades of basic and applied research by innovative researchers and clinical investigators worldwide. The contributing authors to this book have spearheaded much of this research and the Editors have endeavored to create a textbook that is comprehensive in nature while maintaining a specific focus upon the multitude of work that constitutes the spectrum of sepsis research including: pathophysiology; monitoring systems; general support; microbial aspects; complications; and anti-sepsis therapies.

Why Critical Care Evolved METs? In early 2004, when Dr. Michael DeVita informed me that he was cons- ering a textbook on the new concept of Medical Emergency Teams (METs), I was surprised. At Presbyterian-University Hospital in Pittsburgh we int- duced this idea some 15 years ago, but did not think it was revolutionary enough to publish. This, even though, our fellows in critical care medicine training were all involved and informed about the importance of “C- dition C (Crisis),” as it was called to distinguish it from “Condition A (Arrest). ”We thought it absurd to intervene only after cardiac arrest had occurred,because most cases showed prior deterioration and cardiac arrest could be prevented with rapid team work to correct precluding problems. The above thoughts were logical in Pittsburgh, where the legendary Dr. Peter Safar had been working since the late 1950s on improving current resuscitation techniques, ?rst ventilation victims of apneic from drowning, treatment of smoke inhalation, and so on. This was followed by external cardiac compression upon demonstration of its ef?ciency in cases of unexpected sudden cardiac arrest. Dr. Safar devoted his entire professional life to improvement of cardiopulmonary resuscitation. He and many others emphasized the importance of getting the CPR team to o- of-hospital victims of cardiac arrest as quickly as possible.