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Oxford Textbook of Critical Care


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Table of Contents

Section 1: ICU Organisation and Management: The Intensive Care Unit Part 1.1: The Intensive Care Unit 1: Design of the ICU 2: Staffing models in the ICU 3: Rapid response teams for the critically ill 4: In-hospital transfer of the critically ill 5: Pre- and inter-hospital transfer of the critically ill and injured 6: Regional critical care delivery systems 7: Integration of information technology in the ICU 8: Multiple casualties and disaster response in critical care 9: Management of pandemic critical illness Part 1.2: Communication 10: Effective teamwork in the ICU 11: Communication with patients and families in the ICU 12: Telemedicine in critical care Part 1.3: Training 13: Clinical skills in critical care 14: Simulation training for critical care 15: Leadership skills in the ICU Part 1.4: Safety and Quality 16: Patient safety in the ICU 17: Policies, bundles and protocols in critical care 18: Managing biohazards and environmental safety 19: Managing ICU staff welfare, morale and burnout Part 1.5: Governance 20: ICU admission and discharge criteria 21: Resource management and budgeting in critical care 22: Costs and cost-effectiveness in critical care Part 1.6: Research 23: Evidence-based practice in critical care 24: Research ethics in the ICU Part 1.7: Medico-legal and ethical issues 25: Informed consent in the ICU 26: Patient rights in the ICU 27: Medico-legal liability in critical care Part 1.8: Critical Illness Risk Prediction 28: The role and limitations of scoring systems 29: Severity of illness scoring systems 30: Organ failure scoring 31: Genetic and molecular expression patterns in critical illness Section 2: Pharmacotherapeutics Part 2.1: Respiratory drugs 32: Oxygen in critical illness 33: Bronchodilators in critical illness Part 2.2: Cardiovascular drugs 34: Vasopressors in critical illness 35: Vasodilators in critical illness 36: Inotropic agents in critical illness 37: Anti-anginal agents in critical illness 38: Anti-arrhythmics in critical illness 39: Pulmonary vasodilators in critical illness Part 2.3: Gastrointestinal drugs 40: Gastrointestinal motility drugs in critical illness 41: Stress ulcer prophylaxis and treatment drugs in critical illness Part 2.4: Nervous system drugs 42: Sedatives and anti-anxiety agents in critical illness 43: Analgesics in critical illness 44: Antidepressants in critical illness 45: Antiseizure agents in critical illness 46: Inhalational anaesthetic agents in critical illness 47: Muscle relaxants in critical illness 48: Neuroprotective agents in critical illness Part 2.5: Hormonal drugs 49: Hormone therapies in critical illness 50: Insulin and oral anti-hyperglycaemic agents in critical illness Part 2.6: Hematological drugs 51: Anticoagulants and antithrombotics in critical illness 52: Haemostatic agents in critical illness Part 2.7: Antimicrobial and immunological drugs 53: Antimicrobial drugs in critical illness 54: Steroids in critical illness 55: Immunotherapy in critical illness Part 2.8: Fluids and diuretics 56: Colloids in critical illness 57: Crystalloids in critical illness 58: Diuretics in critical illness Section 3: Resuscitation Part 3.1: Respiratory management 59: Airway management in cardiopulmonary resuscitation 60: Artificial ventilation in cardiopulmonary resuscitation Part 3.2 Circulatory management 61: Pathophysiology and causes of cardiac arrest 62: Cardiac massage and blood flow management during cardiac arrest 63: Defibrillation and pacing during cardiac arrest 64: Therapeutic strategies in managing cardiac arrest 65: Post-cardiac arrest arrhythmias 66: Management after resuscitation from cardiac arrest 67: Ethical and end-of-life issues after cardiac arrest Part 3.3: Fluid management 68: Physiology of body fluids 69: Choice of resuscitation fluid 70: Therapeutic goals of fluid resuscitation Section 4: The Respiratory System Part 4.1: Physiology 71: Normal physiology of the respiratory system Part 4: The Respiratory System: Respiratory monitoring 72: Blood gas analysis in the critically ill 73: Pulse oximetry and capnography in the ICU 74: Respiratory system compliance and resistance in the critically ill 75: Gas exchange principles in the critically ill 76: Gas exchange assessment in the critically ill 77: Respiratory muscle function in the critically ill 78: Imaging the respiratory system in the critically ill Part 4.2: Upper airway obstruction 79: Upper airway obstruction in the critically ill Part 4.3: Airway access 80: Standard intubation in the ICU 81: The difficult intubation in the ICU 82: The surgical airway in the ICU Part 4.4: Acute respiratory failure 83: Dyspnoea in the critically ill 84: Pulmonary mechanical dysfunction in the critically ill 85: Hypoxaemia in the critically ill 86: Hypercapnia in the critically ill 87: Cardiovascular interactions in respiratory failure Part 4.5: Ventilatory support 88: Physiology of positive-pressure ventilation 89: Respiratory support with continuous positive airways pressure 90: Non-invasive positive-pressure ventilation 91: Indications for mechanical ventilation 92: Design and function of mechanical ventilators 93: Setting rate, volume, and time in ventilatory support 94: Respiratory support with positive end-expiratory pressure 95: Volume-controlled mechanical ventilation 96: Pressure-controlled mechanical ventilation 97: Pressure support ventilation 98: High-frequency ventilation and oscillation 99: Prone positioning in the ICU 100: Failure to ventilate in critical illness 101: Ventilator trauma in the critically ill Part 4.6: Weaning ventilatory support 102: Assessment and technique of weaning 103: Weaning failure in critical illness Part 4.7: Extracorporeal support 104: Extracorporeal respiratory and cardiac support techniques in the ICU 105: Treating respiratory failure with extracorporeal support in the ICU Part 4.8: Aspiration and inhalation 106: Aspiration of gastric contents in the critically ill 107: Inhalation injury in the ICU Part 4.8: Acute respiratory distress syndrome 108: Pathophysiology of acute respiratory distress syndrome 109: Therapeutic strategy in acute respiratory distress syndrome Part 4.9: Airflow limitation 110: Pathophysiology and causes of airflow limitation 111: Therapeutic approach to bronchospasm and asthma 112: Therapeutic strategy in acute or chronic airflow limitation Part 4.10: Respiratory acidosis and alkalosis 113: Pathophysiology and therapeutic strategy of respiratory acidosis 114: Pathophysiology and therapeutic strategy of respiratory alkalosis Part 4.11: Pneumonia 115: Pathophysiology of pneumonia 116: Diagnosis and management of community-acquired pneumonia 117: Diagnosis and management of nosocomial pneumonia 118: Diagnosis and management of atypical pneumonia Part 4.12: Atelectasis and sputum retention 119: Pathophysiology and prevention of sputum retention 120: Lung recruitment techniques in the ICU 121: Chest physiotherapy and tracheobronchial suction in the ICU 122: Toilet bronchoscopy in the ICU Part 4.13: Pleural cavity disorders 123: Pathophysiology of pleural cavity disorders 124: Management of pneumothorax and bronchial fistulae 125: Management of pleural effusion and haemothorax Part 4.14: Hemoptysis 126: Pathophysiology and causes of haemoptysis 127: Therapeutic approach in haemoptysis Section 5: The Cardiovascular System Part 5.1: Physiology 128: Normal physiology of the cardiovascular system Part 5.2: Cardiovascular monitoring 129: ECG monitoring in the ICU 130: Arterial and venous cannulation in the ICU 131: Blood pressure monitoring in the ICU 132: Central venous pressure monitoring in the ICU 133: Pulmonary artery catheterization in the ICU 134: Mixed and central venous oxygen saturation monitoring in the ICU 135: Right ventricular function in the ICU 136: Cardiac output assessment in the ICU 137: Oxygen transport in the critically ill 138: Tissue perfusion monitoring in the ICU 139: Lactate monitoring in the ICU 140: Measurement of extravascular lung water in the ICU 141: Doppler echocardiography in the ICU 142: Monitoring the microcirculation in the ICU 143: Imaging the cardiovascular system in the ICU Part 5.3: Acute chest pain and coronary syndromes 144: Causes and diagnosis of chest pain 145: Pathophysiology of coronary syndromes 146: Diagnosis and management of non-STEMI coronary syndromes 147: Diagnosis and management of ST-elevation myocardial infarction Part 5.4: Aortic dissection 148: Pathophysiology, diagnosis, and management of aortic dissection Part 5.5: The hypotensive patient 149: Pathophysiology of shock 150: Diagnosis and management of shock in the ICU Part 5.6: Cardiac failure 151: Pathophysiology and causes of cardiac failure 152: Therapeutic strategy in cardiac failure 153: Intra-aortic balloon counterpulsation in the ICU 154: Ventricular assist devices in the ICU Part 5.7: Tachyarrhythmias 155: Causes and diagnosis of tachyarrythmias 156: Therapeutic strategy in tachyarrhythmias Part 5.8: Bradyarrhythmias 157: Causes, diagnosis and therapeutic strategy in bradyarrhythmias Part 5.9: Valvular problems 158: Causes and diagnosis of valvular problems 159: Therapeutic strategy in valvular problems Part 5.10: Endocarditis 160: Pathophysiology and causes of endocarditis 161: Prevention and treatment of endocarditis Part 5.11: Severe hypertension 162: Pathophysiology and causes of severe hypertension 163: Management of severe hypertension in the ICU Part 5.12: Severe capillary leak 164: Pathophysiology of severe capillary leak 165: Management of acute non-cardiogenic pulmonary oedema Part 5.13: Pericardial tamponade 166: Pathophysiology and causes of pericardial tamponade 167: Management of pericardial tamponade Part 5.14: Pulmonary hypertension 168: Pathophysiology and causes of pulmonary hypertension 169: Diagnosis and management of pulmonary hypertension Part 5.15: Pulmonary embolus 170: Pathophysiology and causes of pulmonary embolus 171: Diagnosis and management of pulmonary embolus Section 6: The Gastrointestinal System Part 6.1: Physiology 172: Normal physiology of the gastrointestinal system 173: Normal physiology of the hepatic system Part 6.2: Gastrointestinal monitoring 174: Imaging the abdomen in the critically ill 175: Hepatic function in the critically ill Part 6.3: Gastrointestinal haemorrhage 176: Pathophysiology and causes of upper gastrointestinal haemorrhage 177: Diagnosis and management of upper gastrointestinal haemorrhage in the critically ill 178: Diagnosis and management of variceal bleeding in the critically ill 179: Pathophysiology and causes of lower gastrointestinal haemorrhage 180: Diagnosis and management of lower gastrointestinal haemorrhage in the critically ill Part 6.4: Disordered gastric motility 181: Vomiting and large nasogastric aspirates in the critically ill 182: Ileus and obstruction in the critically ill 183: Diarrhoea and constipation in the critically ill Part 6.5: The acute abdomen in the ICU 184: Pathophysiology and management of raised intra-abdominal pressure in the critically ill 185: Perforated viscus in the critically ill 186: Ischaemic bowel in the critically ill 187: Intra-abdominal sepsis in the critically ill 188: Acute acalculous cholecystitis in the critically ill 189: Management of the open abdomen and abdominal fistulae in the critically ill Part 6.6: Pancreatitis 190: Pathophysiology, diagnosis and assessment of acute pancreatitis 191: Management of acute pancreatitis in the critically ill Part 6.7: Jaundice 192: Pathophysiology and causes of jaundice in the critically ill 193: Management of jaundice in the critically ill Part 6.8: Acute hepatic failure 194: Pathophysiology and causes of acute hepatic failure 195: Diagnosis and assessment of acute hepatic failure in the critically ill 196: Management of acute hepatic failure in the critically ill 197: The effect of acute hepatic failure on drug handling in the critically ill 198: Extracorporeal liver support devices in the ICU Part 6.9: Acute on chronic hepatic failure 199: Pathophysiology, diagnosis, assessment of acute or chronic hepatic failure 200: Management of acute or chronic hepatic failure in the critically ill Section 7: Nutrition Part 7.1: Physiology 201: Normal physiology of nutrition 202: The metabolic and nutritional response to critical illness Part 7.2: Nutritional failure 203: Pathophysiology of nutritional failure in the critically ill 204: Assessing nutritional status in the ICU 205: Indirect calorimetry in the ICU 206: Enteral nutrition in the ICU 207: Parenteral nutrition in the ICU Section 8: The Renal System Part 8.1: Physiology 208: Normal physiology of the renal system Part 8.2: Renal monitoring and risk prediction 209: Monitoring renal function in the critically ill 210: Imaging the urinary tract in the critically ill Part 8.3: Oliguria and acute kidney injury 211: Pathophysiology of oliguria and acute kidney injury 212: Diagnosis of oliguria and acute kidney injury 213: Management of oliguria and acute kidney injury in the critically ill Part 8.4: Renal replacement techniques 214: Continuous haemofiltration techniques in the critically ill 215: Haemodialysis in the critically ill 216: Peritoneal dialysis in the critically ill Part 8.5: Established renal failure 217: The effect of renal failure on drug handling in critical illness 218: The effect of chronic renal failure on critical illness Section 9: The Neurological System Part 9.1: Anatomy and physiology 219: Normal anatomy and physiology of the brain 220: Normal anatomy and physiology of the spinal cord and peripheral nerves Part 9.2: Neurological monitoring 221: Electroencephalogram monitoring in the critically ill 222: Cerebral bloodflow and perfusion monitoring in the critically ill 223: Intracranial pressure monitoring in the ICU 224: Imaging the central nervous system in the critically ill Part 9.3:Sleep disturbance 225: Pathophysiology and therapeutic strategy for sleep disturbance in the ICU Part 9.4: Agitation, confusion and delirium 226: Causes and epidemiology of agitation, confusion and delirium in the ICU 227: Assessment and therapeutic strategy for agitation, confusion and delirium in the ICU Part 9 The Neurological System:The unconscious patient 228: Causes and diagnosis of unconsciousness 229: Management of unconsciousness in the ICU 230: Non-pharmacological neuroprotection in the ICU Part 9.5: Seizures 231: Pathophysiology and causes of seizures 232: Assessment and management of seizures in the critically ill Part 9.6: Intracranial hypertension 233: Causes and management of intracranial hypertension Part 9 The Neurological System: Stroke 234: Epidemiology of stroke 235: Diagnosis and assessment of stroke 236: Management of ischaemic stroke 237: Management of parenchymal haemorrhage Part 9.7: Non-traumatic subarachnoid haemorrhage 238: Epidemiology, diagnosis, and assessment on non-traumatic subarachnoid haemorrhage 239: Management of non-traumatic subarachnoid haemorrhage in the critically ill Part 9.8:Meningitis and encephalitis 240: Epidemiology, diagnosis and assessment of meningitis and encephalitis 241: Management of meningitis and encephalitis in the critically ill Part 9.9: Non-traumatic spinal injury 242: Pathophysiology, causes, and management of non-traumatic spinal injury Part 9 The Neurological System: Neuromuscular syndromes 243: Epidemiology, diagnosis, and assessment of neuromuscular syndromes 244: Diagnosis, assessment, and management of myasthenia gravis and paramyasthenic syndromes 245: Diagnosis, assessment, and management of tetanus, rabies and botulism 246: Diagnosis, assessment, and management of Guillain-Barre syndrome 247: Diagnosis, assessment, and management of hyperthermic crises 248: Diagnosis, assessment, and management of ICU acquired weakness Section 10: The Metabolic and Endocrine Systems Part 10.1: Physiology 249: Normal physiology of the endocrine system Part 10.2: Electrolyte disturbance 250: Disorders of sodium in the critically ill 251: Disorders of potassium in the critically ill 252: Disorders of magnesium in the critically ill 253: Disorders of calcium in the critically ill 254: Disorders of phosphate in the critically ill Part 10.3: Metabolic acidosis and alkalosis 255: Pathophysiology and causes of metabolic acidosis in the critically ill 256: Management of metabolic acidosis in the critically ill 257: Pathophysiology, causes, and management of metabolic alkalosis in the critically ill Part 10.4: Blood glucose control 258: Pathophysiology of glucose control 259: Glycaemic control in critical illness 260: Management of diabetic emergencies in the critically ill Part 10.5: Endocrine disorders 261: Pathophysiology and management of adrenal disorders in the critically ill 262: Pathophysiology and management of pituitary disorders in the critically ill 263: Pathophysiology and management of thyroid disorders in the critically ill 264: Pathophysiology and management of functional endocrine tumours in the critically ill Section 11: The Haematological System Part 11.1: Laboratory monitoring 265: The blood cells and blood count 266: Coagulation monitoring Part 11.2: Haematological therapies 267: Blood product therapy in the ICU 268: Apheresis in the ICU Part 11.3: Disordered coagulation 269: Pathophysiology of disordered coagulation 270: Disseminated intravascular coagulation in the critically ill 271: Prevention and management of thrombosis in the critically ill 272: Thrombocytopenia in the critically ill Part 11.4: Disorders of the blood cells 273: Pathophysiology and management of anaemia in the critically ill 274: Pathophysiology and management of neutropenia in the critically ill 275: Sickle crisis in the critically ill Section 12: The Skin and connective Tissue Part 12.1: Skin and Connective tissue disorders 276: Assessment and management of dermatological problems in the critically ill 277: Vasculitis in the critically ill 278: Rheumatoid arthritis in the critically ill Part 12.2: Wound and pressure sore management 279: Principles and prevention of pressure sores in the ICU 280: Dressing techniques for wounds in the critically ill Section 13: Infection Part 13.1: Diagnosis and surveillance 281: Microbiological surveillance in the critically ill 282: Novel biomarkers of infection in the critically ill Part 13.2: Nosocomial infection 283: Definition, epidemiology and general management of nosocomial infection 284: Healthcare worker screening for nosocomial pathogens 285: Environmental decontamination and isolation strategies in the ICU 286: Antimicrobial selection policies in the ICU 287: Oral, nasopharyngeal and gut decontamination in the ICU 289: Diagnosis, prevention and treatment of device-related infection in the ICU 290: Antibiotic resistance in the ICU Part 13.3: Infection in the immunocompromised 291: Drug-induced depression of immunity in the critically ill 292: HIV in the critically ill Part 13.4: Tropical diseases 293: Diagnosis and management of malaria in the ICU 294: Diagnosis and management of viral haemorrhagic fevers in the ICU 295: Other tropical diseases in the ICU Part 13.5: Sepsis 296: Assessment of sepsis in the critically ill 297: Management of sepsis in the critically ill 298: Pathophysiology of septic shock 299: Management of septic shock in the critically ill Section 14: Inflammation Part 14.1: Physiology 300: Innate immunity and the inflammatory cascade Part 14.2: Organ-specific biomarkers 301: Brain injury biomarkers in the critically ill 302: Cardiac injury biomarkers in the critically ill 303: Renal injury biomarkers in the critically ill Part 14.3: Host response 304: The host response to infection in the critically ill 305: The host response to trauma and burns in the critically ill 306: The host response to hypoxia in the critically ill 307: Host-pathogen interactions in the critically ill 308: Coagulation and the endothelium in acute injury in the critically ill 309: Ischemia-reperfusion injury in the critically ill 310: Repair and recovery mechanisms following critical illness 311: Neural and endocrine function in the immune response to critical illness 312: Adaptive immunity in critical illness 313: Immunomodulation strategies in the critically ill 314: Immunoparesis in the critically ill Part 14.4: Anaphylaxis 315: Pathophysiology and management of anaphylaxis in the critically ill Section 15: Poisoning Part 15.1: Principles of management 316: Role of toxicology assessment in poisoning 317: Decontamination and enhanced elimination of poisons Part 15.2: Management of specific poisons 318: Management of salicylate poisoning 319: Management of acetaminophen (paracetamol) poisoning 320: Management of opioid poisoning 321: Management of benzodiazepine poisoning 322: Management of tricyclic antidepressant poisoning 323: Management of amphetamine or ecstasy 324: Management of digoxin poisoning 325: Management of cocaine poisoning 326: Management of beta-blocker and calcium channel blocker poisoning 327: Management of cyanide poisoning 328: Management of alcohol poisoning 329: Management of carbon monoxide poisoning 330: Management of corrosive poisoning 331: Management of pesticide and agricultural chemical poisoning 332: Management of radiation poisoning Section 16: Trauma Part 16.1: Multiple trauma 333: A systematic approach to the injured patient 334: Pathophysiology and management of thoracic injury 335: Pathophysiology and management of abdominal injury 336: Management of vascular injuries 337: Management of limb and pelvic injuries 338: Assessment and management of fat embolism 339: Assessment and management of combat trauma Part 16.2: Ballistic trauma 340: Pathophysiology of ballistic trauma 341: Assessment and management of ballistic trauma Part 16.3: Traumatic brain injury 342: Epidemiology and Pathophysiology of traumatic brain injury 343: Assessment of traumatic brain injury 344: Management of traumatic brain injury Part 16.4 Spinal cord injury 345: Assessment and immediate management of spinal cord injury 346: Ongoing management of the tetraplegic patient in the ICU Part 16.5: Burns 347: Pathophysiology and assessment of burns 348: Management of burns in the ICU Section 17: Physical Disorders Part 17.1: Drowning 349: Pathophysiology and management of drowning Part 17.2: Electrocoution 351: Pathophysiology and management of electrocution Part 17.3: Altitude- and depth-related disorders 352: Pathophysiology and management of altitude related disorders 353: Pathophysiology and management of depth related disorders 354: Pathophysiology and management of hypothermia Part 17.4: Rhabdomyolysis 355: Pathophysiology and management of rhabdomyolysis Section 18: Pain and Sedation: Part 18.1: Pain 356: Pathophysiology and assessment of pain 357: Pain management in the critically ill Part 18.2: Sedation 358: Sedation assessment in the critically ill 359: Management of sedation in the critically ill Section 19: General surgical and obstetric intensive Care: Part 19.1: Optimisation strategies for the high-risk surgical patient 360: Identification of the high-risk surgical patient 361: Peri-operative optimisation of the high risk surgical patient Part 19.2: General post-operative intensive care 362: Post-operative ventilatory dysfunction management in the ICU 363: Post-operative fluid and circulatory management in the ICU 364: Surgical enhanced recovery programs in the ICU Part 19.3: Obstetric intensive care 365: Obstetric physiology and special considerations in ICU 366: Pathophysiology and management of pre-eclampsia, eclampsia and HELLP syndrome 367: Pathophysiology and management of critical illness in pregnancy Section 20: Specialized intensive care Part 20.1: Specialized surgical intensive care 368: Intensive care management after cardiothoracic surgery 369: Intensive care management after neurosurgery 370: Intensive care management after vascular surgery 371: Intensive care management in hepatic and other abdominal organ transplantation 372: Intensive care management in cardiac transplantation 373: Intensive care management in lung transplantation Part 20.2: Oncological intensive care 374: ICU selection and outcome of patients with haematologic malignancy 375: Management of the bone marrow transplant recipient in ICU 376: Management of oncological complications in the ICU Section 21: Recovery From Critical Illness Part 21.1: In hospital recovery from critical illness 377: Chronic critical illness 378: Promoting physical recovery in critical illness 379: Promoting renal recovery in critical illness 380: Recovering from critical illness in hospital Part 21.2: Complications of critical illness 381: Physical consequences of critical illness 382: Neurocognitive impairment after critical illness 383: Affective and mood disorders after critical illness Part 21.3: Out-of-hospital support after critical illness 384: Long-term weaning centres in critical care 385: The ICU survivor clinic 386: Rehabilitation from critical illness after hospital discharge Section 22: End Of Life Care Part 22.1: Withdrawing and withholding treatment 387: Ethical decision making in withdrawing and withholding treatment 388: Management of the dying patient Part 22.2: Management of the potential organ donor 389: Beating heart organ donation 390: Non-beating heart organ donation Part 22.3: Post-mortem diagnosis 391: Post-mortem examination in the ICU

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Highly Commended in the Anaesthesia category of the British Medical Association Book Awards 2017.

About the Author

Dr. Webb is a Clinical Professor in the Department of Medicine at UBC and VP Medicine for the Fraser Health Authority where he provides executive leadership and strategic oversight to the quality and safety of clinical care, including Infection Control, Risk Management and Legal Services. He also provides physician leadership, and oversees the development of research and education. In addition to his appointment as Special Advisor to the Dean, Faculty of Medicine, UBC, he holds a similar appointment at Simon Fraser University. As a Consultant Physician in Critical Care Medicine he was instrumental in building academic critical care as a medical administrator, clinical researcher, educator and consultant physician helping to develop one of the strongest Critical Care research groups in the world. He is author of 75 papers and reviews, seven textbooks, 22 book chapters and eight monographs. Dr. Angus is Distinguished Professor and Chair of the Department of Critical Care Medicine at the University of Pittsburgh School of Medicine and UPMC Health System. He holds secondary appointments in Medicine, Health Policy and Management, and Clinical and Translational Science. He completed his medical school and residency training at the University of Glasgow and fellowship training at the University of Pittsburgh. Dr. Angus' research, funded principally by the NIH, focuses on clinical, epidemiologic and translational studies of sepsis, pneumonia, and multisystem organ failure and on health services research of the organization and delivery of critical care services. He has published several hundred papers, is section editor for "Caring for the Critically Ill" for JAMA, and the recipient of numerous awards. Dr Finfer is a practicing critical care physician with an appointment as a Senior Staff Specialist at Royal North Shore Hospital and Director of Intensive Care at the Sydney Adventist Hospital. He is an Adjunct Professor at the University of Sydney Medical School, a past-Chair of the Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. He is a council member of the International Sepsis Forum, the Global Sepsis Alliance, and a member of the World Sepsis Day Steering Committee. Dr Finfer is a Professorial Fellow in the Critical Care and Trauma Division at The George Institute for global Health. He is active in forging major international research collaborations that have conducted large scale clinical trials. Simon is also an Editor of the Critical Care Section Editor for The Oxford Textbook of Medicine (6th Ed.), and was a Critical Care guest editor for The New England Journal of Medicine from 2011 to 2014. Professor Luciano Gattiononi is Professor in Anesthesiology and Intensive Care Medicine, University of Milan as well as Chief of the Department of Anesthesia, Resuscitation and Pain Therapy, Policlinico Hospital of Milan. His research is focused on the pathophisiology and treatment of acute respiratory failure, including prone positioning, sepsis and acid base disorders. He has published more than 200 research articles and reviews in peer reviewed journal. In the early 1980's he worked on the quantitative analysis of thoracic CT imaging, culminating in the "baby lung" (1980s) and lung recrutability (2000s) concepts. He was awarded with the Life Time Achievement Award by the American Society of Anesthesiology and is Honorary Member of the German Society of Anesthesiology and Intensive Care, and Fellow of the Royal College of Physicians. Mervyn Singer is Professor of Intensive Care Medicine at University College London. His primary research interests are sepsis and multi-organ failure, infection, shock and haemodynamic monitoring. He developed an oesophageal Doppler haemodynamic monitor that is now in widespread use worldwide, the use of which has been shown in multiple studies to improve outcomes after major surgery and reduce length of stay. He has led on a number of important multi-centre trials in critical care. He has authored various papers and textbooks including the Oxford Handbook of Critical Care, now in its 3rd Edition, and is a Council member of the International Sepsis Forum. He was the first UK intensivist to be awarded Senior Investigator status by the National Institute for Health Research, and to be invited to give plenary lectures at the European and US Intensive Care Congress


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