Applied Physiology in Intensive Care Medicine978-3-642-01769... · 2017-08-26 · Applied...
Transcript of Applied Physiology in Intensive Care Medicine978-3-642-01769... · 2017-08-26 · Applied...
M. R. Pinsky · L. Brochard · J. Mancebo · G. Hedenstierna (Eds.)
Applied Physiology in Intensive Care Medicine
Applied Physiology in Intensive Care Medicine
123
With 155 Figures and 27 Tables
second edition
M. R. Pinsky · L. Brochard · J. Mancebo G. hedenstierna (eds.)
3550 Terrace streetPittsburgh, Pa 15261 France
The articles in this book appeared in the journal „intensive care Medicine“
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hôpital henri MondorDept. intensive care Medicine51 av. Maréchal Lattre de Tassigny94010 créteil cX
hospital de sant PauDept. intensive care Medicine avda. s. antonio M. claret, 167
Dept. clinical Physiology
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ISBN 978-3-642-01768-1 e-ISBN 978-3-642-01769-8DOI 10.1007/978-3-642-01769-8
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MichaeL R. Pinsky, MD
JoRDi ManceBo, MD
LaURenT BRochaRD, MD
GÖRAN HEDENSTIERNA, MD
Springer is part of Springer Science+Business Media (www.springer.com)
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The practice of intensive care medicine is at the very forefront of titration of treatment and monitoring response. The substrate of this care is the critically ill patient who, by definition, is at the limits of his or her physiologic reserve. such patients need immediate, aggressive but balanced life-altering interventions to minimize the detrimental aspects of acute illness and hasten recovery. Treatment decisions and response to therapy are usually assessed by measures of physiologic function, such as assessed by cardio-respiratory monitoring. however, how one uses such information is often unclear and rarely supported by prospective clinical trials. in reality, the bedside clinician is forced to rely primarily on physiologic principles in determining the best treatments and response to therapy. however, the physiologic foundation present in practicing physicians is uneven and occasionally supported more by habit or prior training than science.
a series of short papers published in intensive care Medicine since 2002 under the heading Physiologic notes attempts to capture the essence of the physiologic perspectives
of applied physiology and underscore what is known and how measures and monitoring interact with organ system function and response to therapy. This collection of physiologic
represent an up-to-date and invaluable compendium of practical bedside knowledge essential to the effective delivery of acute care medicine. although this text can be read from cover to cover, the reader is encouraged to use this text as a reference source reading individual Physiologic notes and Review articles as they pertain to specific clinical issues. in that way the relevant information will have immediate practical meaning and hopefully become incorporated into routine practice.
We hope that the reader finds these papers and reviews useful in their practice and enjoy reading them as much as we enjoyed editing the original articles that it comprises.
Introduction
This volume was created to address this fundamental unevenness in our understanding the associated review articles over the same interval that also addressed these central issues.
perspectives and reviews, written by some of the most respected experts in the field,
volume combines the complete list of these Physiologic notes up until February 2009 with
Michael R. Pinsky, MDLaurent Brochard, MD
Jordi Mancebo, MDGöran Hedenstierna, MD
that underpin both our understanding of disease and response to therapy. This present
1. Physiological Notes
1.1 Pulmonary
1.1.1 Respiratory Mechanics
Intrinsic (or auto-) positive end-expiratory pressure during controlled mechanical ventilation . . . . . . . . . 3Laurent Brochard
Intrinsic (or auto-) positive end-expiratory pressure during spontaneous or assisted ventilation . . . . . . . . 7Laurent Brochard
Work of breathing . . . . . . . . . . . . . . . . . . . . . . . . 11
Interpretation of airway pressure waveforms . . . . . . 15
1.1.2 Gas exchange
Robert Rodríguez-Roisin, Josep Roca
Amal Jubran
I 22 I 2
Björn Jonson, Laurent Brochard
1.2. Cardiovascular:
Pulmonary vascular resistance: A meaningless
Robert Naeije
Clinical significance of pulmonary artery occlusion
Ventricular interdependence: how does it impact
Cyclic changes in arterial pressure during
François Jardin
Contents
PETER D. WAGNER
THEODOROS VASSILAKOPOULOS
JUKKA TAKALA
. . . . . . . . . . . . . . . 17
. . . . . . . . . . . . . . . . 21
Dead space . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
. . . . . . . . . . . . . . . . . . . . . . . . 29
Mechanisms of hypoxemia . . . . . . . . . . . . . . . . . . 41
Pulse oximetry . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Effects of body temperature on blood gases . . . . . . 49
Venous oximetry . . . . . . . . . . . . . . . . . . . . . . . . . 53
. . . . . . . . . . 57
. . . . . . 61
variable? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Pulmonary artery occlusion pressure . . . . . . . . . . . 69
pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Pulmonary capillary pressure . . . . . . . . . . . . . . . . 77
on hemodynamic evaluation in clinical practice? . . . 81
mechanical ventilation . . . . . . . . . . . . . . . . . . . . . 85
Measurement of respiratory system resistance during mechanical ventilation
Umberto Lucangelo, luis Blanch
in mechanically ventilated COPD patients using the Campbell diagram
The multiple inert gas elimination technique (MIGET)
influence of cardiac output on oxygenation
Understanding wasted/ineffective efforts
CLAUDE GUERIN, JEAN-CHRISTOPHE RICHARD
A T
Alveolar ventilation and pulmonary blood flow. : .
Evans R. Fern rez, Rolf D. HubmayrÁ É
/F O ratio and F O :. . . . . . . .
the V /Q concept . . . . . . . . . . . . . . . . . . . . . . . . . 37
Relation between PaO
Hypoxemia due to increased venous admixture:
a mathematical description J ÉRÔM E
Michael R. Pinsky
Michael R. Pinsky
ndez-P
Aboab, Bruno Louis,
Frank Bloos, Konrad Reinhart
Andreas Bacher
Belen Cabello, Jordi Mancebo
Jukka Takala
François Jardin
Enrico Calzia, Peter Radermacher
ContentsViii
2. Physiological Reviews
2.1. Measurement techniques
Fluid responsiveness in mechanically ventilated
Karim Bendjelid, Jacques-André Romand
Different techniques to measure intra-abdominal
Manu L. N. G. Malbrain
Tissue capnometry: does the answer lie
Alexandre Toledo Maciel, Jacques Creteur, Jean-Louis Vincent
Alexandre Lima, Jan Bakker
2.2. Physiological processes
SAiram Parthasarathy, Martin J. Tobin
Magnesium in critical illness: metabolism,
Luis J. Noronha, George M. Matuschak
Pulmonary endothelium in acute lung injury:
Pulmonary and cardiac sequelae of subarachnoid
Carol S. A. Macmillan,
Paul McLoughlin, Brian P. Kavanagh
Right ventricular function and positive pressure ventilation in clinical practice: from hemodynamic
Antoine Vieillard-Baron
Acute right ventricular failure – from
Alexandre Mebazaa, Peter Karpati, Estelle Renaud, Lars Algotsson
Michael Piagnerelli, Karim Zouaoui-Boudjeltia, Michel Vanhaeverbeek, Jean-Louis Vincent
Hypotension during intermittent hemodialysis:
Frédérique Schortgen
1.4. Cerebral Function
Peter J. D. Andrews
Peter J. D. Andrews, Giuseppe Citerio
Ultrasonographic examination of the venae cavae . . Antoine Vieillard-Baron, François Jardin
. . . . . . . . . . . . . . . . . . . . . . . .
1.3. Metabolism and Renal Function
Daniel De Backer
Rinaldo Bellomo, John A. Kellum, Claudio Ronco
Lactic acidosis . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
new insights into an old problem . . . . . . . . . . . . . . 99
and basic concepts . . . . . . . . . . . . . . . . . . . . . . . . 105
and technology . . . . . . . . . . . . . . . . . . . . . . . . . . 109
. . . . . . . . . . . . . . . . . . . . 113
. . . . . . . . . . . . . . . . . . . . . . . 123
patients: a review of indices used in intensive care . . 133
blood flow monitoring
and microdialysis .
Passive leg raising
pressure (IAP): time for a critical re-appraisal . . . . . 143
under the tongue? . . . . . . . . . . . . . . . . . . . . . . . . 159
Noninvasive monitoring of peripheral perfusion . . . 169
181
185
Sleep in the intensive care unit . . . . . . . . . . . . . . . 191
assessment, and treatment . . . . . . . . . . . . . . . . . . 201
from basic science to the critically ill . . . . . . . . . . . . 215
haemorrhage: time for active management? . . . . . 229
ventilatory strategies . . . . . . . . . . . . . . . . . . . . . . 241
subsets to respirator settings . . . . . . . . . . . . . . . . . 251
pathophysiology to new treatments . . . . . . . . . . . 261
Red blood cell rheology in sepsis . . . . . . . . . . . . . 273
XAVIER MONNET AND JEAN-LOUIS TEBOUL
ANUJ BHATIA, ARUN KUMAR GUPTA
ANUJ BHATIA, ARUN KUMAR GUPTA
Part one: Intracranial pressure and cerebral
Part two: Cerebral oxygenation monitoring
Defining renal failure: physiological principles . . . . . 93
Intracranial pressure. Part one: Historical overview
Intracranial pressure. Part two: Clinical applications
Giuseppe Citerio,
Neuromonitoring in the intensive care unit.
Neuromonitoring in the intensive care unit.
Ian S. Grant, Peter J. D. Andrews
John G. Laffey, Donal O’Croinin, l
François Jardin,
stylianos E. Orfanos, Irene Mavrommati,
Permissive hypercapnia – role in protective lung
Io nna Korovesi, Charis Roussos a
Contents iX
Diaphragmatic fatigue during sepsis
Sophie Lanone, Camille Taillé, Jorge Boczkowski, Michel Aubier
Jean-Roger Le Gall
jean-Louis Vincent, Daniel De Backer
Suveer Singh, Timothy W. Evans
Ventilator-induced lung injury: from the bench
Lorraine N. Tremblay, Arthur S. Slutsky
Remembrance of Weaning Past:
Martin J. Tobin3. Seminal Studies in Intensive Care
Manipulating afterload for the treatment of acute
pressure into mechanical ventilation:
Konrad J. Falke
Elastic pressure-volume curves in acute lung injury and acute respiratory distress syndrome Björn Jonson
Luciano Gattinoni, Antonio Pesenti
The effects of anesthesia and muscle paralysis on
Göran Hedenstierna, Lennart Edmark
. . . ..
Normalizing physiological variables in acute illness:
Brian P. Kavanagh, L. Joanne Meyer
SHANE M. TIBBY, ANDREW DURWARD
THEODOROS VASSILAKOPOULOS
Hypothalamic-pituitary dysfunction in critically ill patients with traumatic and nontraumatic brain
Ioanna Dimopoulou, Stylianos Tsagarakis
Matching total body oxygen consumption and
Pierre Squara
Stress-hyperglycemia, insulin and
Paul E. Marik, Murugan Ragavanh
gradient across a pulmonary artery band Interpretation of the echocardiographic pressure
in the setting of a univentricular heart
Ventilator-induced diaphragm dysfunction: the clinical relevance of animal models
Understanding organ dysfunction in hemophagocytic lymphohistiocytosis
Interactions between respiration and systemic hemodynamics. Part I: basic concepts
Interactions between respiration and systemic hemodynamics. Part II: practical implications in critical care
immunomodulation in sepsis . . . . . . . . . . . . . . . 283
injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
delivery: a crucial objective? . . . . . . . . . . . . . . . . 303
five reasons for caution . . . . . . . . . . . . . . . . . . . . 313
. . . . . . . . . 321
. . . . . . . . 327
. . . . . . . 337
a retrospective . . . . . . . . . . . . . . . . . . . . . . . . . 363
. . . . . . . . 367
The concept of “baby lung” . . . . . . . . . . . . . . . . . 375
the respiratory system . . . . . . . . . . . . . . . . . . . . 385
and septic shock . . . . . . . . . . . . . . . . . . . . . . . . 395
The use of severity scores in the intensive care . . . . 403
409
Organ dysfunction during sepsis . . . . . . . . . . . . . 417
to the bedside . . . . . . . . . . . . . . . . . . . . . . . . . . 429
the Seminal Studies . . . . . . . . . . . . . . . . . . . . . . 439
. . . . . . . . . 449
459
. . . . . . . . . . . . . . . . . . . . . . . . . . 467
CAROLINE CRÉPUT, LIONEL GALICIER, SOPHIE BUYSE ELIE AZOULAY
FRANÇOIS FEIHL , ALAIN F. BROCCARD
Subject Index
FRANÇOIS FEIHL , ALAIN F. BROCCARD
Nosocomial pneumonia . . . . . . . . . . . . . . . . . . . 355
CLAUDE PERRET, JEAN-FRANÇOIS ENRICO
Waldemar G. Johanson, Lisa L. Dever
The introduction of positive endexpiratory
controversy . . . . . . . . . . . . . . . . . . . . . . . . . . . .Oxygen transport—the oxygen delivery
heart failure. A historical summary . . . . . . . . . . . . 351
Jérôme AboabRéanimation Médicalehôpital henri Mondorcréteil, France
Lars AlgotssonDepartment of anaesthesiology– heart-Lung DivisionUniversity hospital of Lund,22185 Lund, sweden
Peter J. D. AndrewsDepartment of anaesthetics, intensive care and Pain MedicineUniversity of edinburgh, Western General hospitalcrewe Road, eh4 2XU edinburgh, scotland, Uk
Michel AubierinseRM U 700 and iFR 02, Facult Xavier Bichat16 rue henri huchard, 75018 Paris, France
Andreas BacherDepartment of anesthesiology and General intensive careMedical University of Vienna, akhWähringer Gürtel 18–20, 1090 Vienna, austria
Jan BakkerDepartment of intensive care, erasmus McUniversity Medical center RotterdamP.o. Box 2040, 3000 ca Rotterdam, The netherlands
Rinaldo BellomoDepartment of intensive care and Division of surgeryaustin & Repatriation Medical centre3084 heidelberg, Melbourne, Victoria, australia
Karim Bendjelidsurgical intensive care Division, Geneva University hospitals1211 Geneva 14, switzerland
critical care center hospital de sabadellParc Taulis/n, 08208 sabadell, spain
Frank Bloosklinik für anästhesiologie und intensivtherapieklinikum der Friedrich-schiller-Universitäterlanger allee 101, 07747 Jena, Germany
Jorge BoczkowskiinseRM U 700 and iFR 02, Facult Xavier Bichat16 rue henri huchard, 75018 Paris, France
Laurent Brochard Réanimation Médicalehôpital henri Mondor, Université Paris 12, inseRM U651, 94010 créteil, France
Contributors
Department of Clinical Immunology, and Hôpital Saint-Louis, Medical ICU, AP--HP, -University Paris-7 Diderot, UFR de Médecine, 1 avenue Claude Vellefaux, 75010 Paris, France
Elie Azoulay
Department of Anaesthesia, Addenbrooke’s Hospital, Hills Road, CB2 2QQ Cambridge, UK
Anuj Bhatia
Medical Intensive Care Unit, Regions Hospital Pulmonary and Critical Care Division,
MN 55101-2595, USA
Alain F. Broccard
Regions Hospital, St Paul,
Department of Clinical Immunology, and Hôpital Saint-Louis, Medical ICU, AP---HP, University Paris-7 Diderot, UFR de Médecine, 1 avenue Claude Vellefaux, 75010 Paris, France
Sophie Buyse
Luis Blanch
ContributorsXii
Lisa L. DeverUMDnJ-new Jersey Medical school, Va new Jersey health care system385 Tremont, east orange, nJ 07018, Usa
Ioanna Dimopoulousecond Department of critical care Medicine, attikon hospital, Medical school national and kapodistrian University of athens2 Pesmazoglou street, 14561 kifissia, athens, Greece
Lennart EdmarkDepartment of anesthesia and intensive carecentral hospital72335 Vasteras, sweden
Jean-François EnricoFormer chief of intensive care Unithôpital des cadolles,neuchâtel, switzerland
Timothy W. Evansimperial college school of MedicineDepartment of intensive care MedicineRoyal Brompton hospital, London, Uk
Konrad J. Falkeklinik für anaesthesiology und operative intensivmedizin Berlincampus Virchow klinikum,charite, Berlin, Germany
Evans R. Fernández PérezMayo clinic college of Medicine
Jean-Roger Le GallDepartment of intensive care Medicinesaint-Louis University hospital, Paris, France
Luciano Gattinoniistituto di anestesia e RianimazioneFondazione iRccs ospedale Maggiore PoliclinicoMangiagalli, Regina elena di Milano, Università degli studiVia Francesco sforza 35, 20122 Milan, italy
Ian S. GrantDepartment of anaesthesia, University of edinburgh,Western General hospital, edinburgh, scotland, Uk
Jacques CreteurDepartment of intensive care, erasme University hospital, Free University of BrusselsRoute de Lennik 808, 1070 Brussels, Belgium
Enrico Calziasektion anästhesiologische Pathophysiologie und Verfahrensentwicklung Universitätsklinik für anästhesiologie, Universität UlmParkstrasse 11, 89070 Ulm, Germany
Giuseppe Citerioneurorianimazione, Dipartimento di anestesia e Rianimazionenuovo ospedale san GerardoVia Donizetti 106, 20052 Monza, italy
Belen Cabellohospital santa creu i sant Pau, servicio de Medicina intensivaav/ sant antoni Maria claret 167, cP 08025 Barcelona, spain
and Hôpital Saint-Louis, Medical ICU, AP--HP, -University Paris-7 Diderot, UFR de Médecine, 1 avenue Claude Vellefaux, 75010 Paris, France
Caroline Créput Department of Clinical Immunology,
Evelina Children’s Hospital, Guy’s and Saint Thomas’ NHS Trust, Paediatric Intensive Care Unit, SE1 7EH London, UK
Andrew Durward
1011 Lausanne, Switzerland
University Hospital (CHUV) and Lausanne University (UNIL),
François Feihl Division of Clinical Pathophysiology,
Department of Clinical Immunology, and Hôpital Saint-Louis, Medical ICU, AP--HP, -University Paris-7 Diderot, UFR de Médecine, 1 avenue Claude Vellefaux, 75010 Paris, France
Lionel Galicier Daniel De BackerDepartment of intensive care, erasme University hospitalFree University of BrusselsRoute de Lennik 808, 1070 Brussels, Belgium
55905 Mn , UsaRochester,
Contributors Xiii
Bruno Louisinserm Unit 651Department of Medecine Paris 12créteil, France
Umberto LucangeloDepartment of Perioperative Medicine,intensive care and emergency, cattinara hospital, Trieste University school of Medicine34139 Trieste, italy
Jordi Mancebohospital santa creu i sant Pau, servicio de Medicina intensivaav/ sant antoni Maria claret 167, cP 08025 Barcelona, spain
Alexandre Toledo MacielDepartment of intensive care, erasme University hospital, Free University of BrusselsRoute de Lennik 808, 1070 Brussels, Belgium
Carol S. A. MacmillanUniversity of Dundee, Department of anaesthesianinewells hospital, Dundee DD1 9sy, Uk
Brian P. KavanaghDepartment of critical care Medicine, hospital for sick children555 University avenue, Toronto, onT, M5G 1X8, canada
John A. KellumDivision of critical care Medicine, scaife hallUniversity of Pittsburgh Medial centre,Terrace street, Pittsburgh, Pa 15260, Usa
Peter KarpatiDepartment of anaesthesiology and critical care Medicinehopital Lariboisie`re, 2 Rue ambroise Pare75475 Paris cedex 10, France
Waldemar G. Johanson †UMDnJ-new Jersey Medical school185 south orange, newark, nJ 07018, Usa
Björn JonsonDepartment of clinical PhysiologyUniversity hospital of Lund22185 Lund, sweden
Amal JubranDivision of Pulmonary and critical care Medicine edward hines Jr. Veterans affairs hospitalRoute 111 n, hines, iL, 60141, Usa
John G. LaffeyDepartment of anaesthesia, University college hospitalGalway and clinical sciences institute, national University of ireland, Galway, ireland
Sophie LanoneinseRM U 700 and iFR 02, Facult Xavier Bichat16 rue henri huchard, 75018 Paris, France
Alexandre LimaDepartment of intensive care, erasmus McUniversity Medical center RotterdamP.o. Box 2040, 3000 ca Rotterdam, The netherlands
Ioanna KorovesiDepartment of critical care & Pulmonary Medicine and “M. simou” LaboratoryMedical school, University of athens, evangelismos hospital45–47 ipsilandou st., 10675 athens, Greece
Göran Hedenstiernaclinical Physiology, Department of Medical sciences, University hospital75185 Uppsala, sweden
Rolf D. HubmayrMayo clinic college of Medicine
François Jardinhôpital ambroise Paré,service de Réanimation Médicale,9 avenue charles de Gaulle, 92104 Boulogne, France
Department of Anaesthesia, Addenbrooke’s Hospital, Hills Road, CB2 2QQ Cambridge, UK
Neuroscience Critical Care Unit, Addenbrooke’s Hospital, Hills Road, CB2 2QQ Cambridge, UK
Arun Kumar Gupta
and
Hôpital de la Croix Rousse and Université de Lyon, Service de Réanimation Médicale, 103 Grande Rue de la Croix Rousse, 69004 Lyon, France
Claude Guerin
55905 Mn , UsaRochester,
ContributorsXiV
Stylianos E. Orfanos2nd Department of critical care, University of athens Medical school, attikon hospital1, Rimini st., 12462 haidari (athens), Greece
Sairam ParthasarathyDivision of Pulmonary and critical care, Medicine edward hines Jr.Veterans administrative hospital, Loyola University of chicago stritch school of MedicineRoute 111 n, hines, iL 60141, Usa
Michael PiagnerelliDepartment of intensive care, erasme University hospitalFree University of Brussels808 route de Lennik, 1070 Brussels, Belgium
Claude PerretFormer chief of intensive care DepartmentUniversity hospital of Lausanne, switzerlandRuelle des halles 4, ch-1095 Lutry, switzerland
Antonio PesentiDipartimento di Medicina Perioperatoria e Terapia intensiva a.o. ospedale s.GerardoMonza, Università degli studiMilan-Bicocca, italy
Robert Naeije Department of Physiology,Faculty of Medicine of the Free University of Brussels, erasme campus808 Route de Lennik, cP 604, 1070 Brussels, Belgium
Luis J. NoronhaDivision of Pulmonary, critical care and occupational MedicineDepartments of internal Medicine and Pharmacological and Physiological scienceschool of Medicinesaint Louis University, 3635 Vista ave., saint Louis, Mo 63110-0250, Usa
O’CroininDepartment of Physiology, University college DublinDublin, ireland
Paul McLoughlinDepartment of Physiology, University college DublinDublin, ireland
Alexandre MebazaaDepartment of anaesthesiology and critical care Medicinehopital Lariboisière, 2 Rue ambroise Pare75475 Paris cedex 10, France
L. Joanne MeyerDepartment of Medicine, st. Joseph’s hospitalToronto, canada
Paul E. MarikDepartment of critical care MedicineUniversity of Pittsburgh Medical center640a scaife hall, 3550 Terrace street, Pittsburgh, Pa, 15261, Usa
George M. MatuschakDivision of Pulmonary, critical care and occupational MedicineDepartments of internal Medicine and Pharmacological and Physiological scienceschool of Medicinesaint Louis University, 3635 Vista ave., saint Louis, Mo 63110-0250, Usa
Irene MavrommatiDepartment of critical care & Pulmonary Medicine and “M. simou” LaboratoryMedical school, University of athens, evangelismos hospital45–47 ipsilandou st., 10675 athens, Greece
Hôpital de Bicêtre, AP-HP, Service de réanimation médicale, 78 rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France
Université Paris-Sud, Equipe d’accueil EA 4046, Faculté de Médecine Paris-Sud, 94270 Le Kremlin-Bicêtre, France
Xavier Monnet
and
Manu L. N. G. MalbrainMedical intensive care Unit, acZa campus stuivenbergLange Beeldekensstraat 267, B-2060 antwerpen, Belgium
Donall
XV
Camille TailléinseRM U 700 and iFR 02, Facult Xavier Bichat16 rue henri huchard, 75018 Paris, France
Arthur S. SlutskyQueen Wing, st. Michael’s hospital30 Bond st., Toronto, onT, M5B 1W8, canada
Pierre SquaraceRic clinique ambroise Pare27 Boulevard Victor hugo, 92200 neuilly-sur-seine, France
Claudio RoncoDivisione di nefrologia, ospedale san BortoloVia Ridolfi, 36100 Vicenza, italy
Frédérique SchortgenRéanimation Médicale et infectieusehôpital Bichat-claude Bernard75018 Paris, France
Suveer Singhchelsea and Westminster hospitalDepartment of intensive care Medicine369 Fulham Road, sW10 9nh London, Uk
Estelle RenaudDepartment of anaesthesiology and critical care Medicinehopital Lariboisie`re, 2 Rue ambroise Pare75475 Paris cedex 10, France
Charis RoussosDepartment of critical care & Pulmonary Medicine and “M. simou” LaboratoryMedical school, University of athens, evangelismos hospital45–47 ipsilandou st., 10675 athens, Greece
Josep Rocaservei de Pneumologia, hospital clínicinstitut d’investigaciones Biomédiques ausgust Pi i sunyer, Universitat de BarcelonaVillarroel 170, 08036 Barcelona, spain
Robert Rodríguez-Roisinservei de Pneumologia, hospital clínicinstitut d’investigaciones Biomédiques ausgust Pi i sunyer, Universitat de BarcelonaVillarroel 170, 08036 Barcelona, spain
Peter Radermachersektion anästhesiologische Pathophysiologie und Verfahrensentwicklung Universitätsklinik für anästhesiologie, Universität UlmParkstrasse 11, 89070 Ulm, Germany
Konrad Reinhartklinik für anästhesiologie und intensivtherapieklinikum der Friedrich-schiller-Universitäterlanger allee 101, 07747 Jena, Germany
Hôpital de la Croix Rousse and Université de Lyon, Service de Réanimation Médicale, 103 Grande Rue de la Croix Rousse, 69004 Lyon, France
Jean-Christophe Richard
Department of Intensive Care Medicine, University Hospital Bern (Inselspital), University of Bern, 3010 Bern, Switzerland
Jukka Takala
Hôpital de Bicêtre, AP-HP, Service de réanimation médicale, 78 rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France
Université Paris-Sud, Equipe d’accueil EA 4046, Faculté de Médecine Paris-Sud, 94270 Le Kremlin-Bicêtre, France
Jean-Louis Teboul
and
Paediatric Intensive Care Unit, Evelina Children’s Hospital, Guy’s and Saint Thomas’ NHS Trust, SE1 7EH London, UK
Shane M. Tibby
Contributors
Murugan Raghavanconemaugh Memorial Medical centerJohnstown, Pennsylvania, Usa
Michael R. PinskyDepartment of critical care MedicineUniversity of Pittsburgh Medical center, 604 scaife, 3550 Terrace street, Pittsburgh, Pa 15261, Usa
Jacques-André Romandsurgical intensive care Division, Geneva University hospitals1211 Geneva 14, switzerland
Department of Critical Care and Pulmonary Services, University of Athens Medical School, Evangelismos Hospital,
Critical Care Department, Evangelismos Hospital, 45---47 Ipsilandou Strasse, 10675 Athens, Greece
Department of Medicine, Division of Physiology, University of California, San Diego, 9500 Gilman Drive, Dept. 0623A, La Jolla CA 92093-0623A, USA
Peter D. Wagner
Theodoros Vassilakopoulos
and
Stylianos TsagarakisDepartment of endocrinology, athens Polyclinicathens, Greece
Michel Vanhaeverbeekexperimental Medicine Laboratory, andré Vésale hospitalMontigny-le-Tilleul, Belgium
Antoine Vieillard-BaronUniversity hospital ambroise Paré, assistance Publique hôpitaux de ParisMedical intensive care Unit9 avenue charles de Gaulle, 92104 Boulogne cedex, France
Jean-Louis VincentDepartment of intensive care, erasme University hospitalFree University of BrusselsRoute de Lennik 808, 1070 Brussels, Belgium
Karim Zouaoui-Boudjeltiaexperimental Medicine Laboratory, andré Vésale hospitalMontigny-le-Tilleul, Belgium
45---47 Ipsilandou Street, 10675 Athens, Greece
Lorraine N. TremblayDepartment of surgerysunnybrook and Women’s health sciences centerToronto, ont., canada
ContributorsXVi
Martin J. TobinDivision of Pulmonary and critical care Medicineedward hines Jr. Va hospital, 111n5th avenue and Roosevelt Roadhines, illinois 60141, Usa