Emilio Diaz - Böcker

Infections and their complications are a very important clinical area in the intensive care unit setting. Community-acquired infections and nosocomial infections both contribute to the high level of disease acquisition common among critically ill patients. The accurate diagnosis of nosocomial infections and the provision of appropriate therapies, including antimicrobial therapy effective against the identified agents of infection, have been shown to be important determinants of patient outcome.Critical care practitioners are in a unique position in dealing with infectious diseases. They are often the initial providers of care to seriously ill patients with infections. Additionally, they have a responsibility to ensure that nosocomial infections are prevented and that antimicrobial resistance is minimized by prudently employing antibiotic agents. It is the editors' hope that this book will provide clinicians practicing in the intensive care unit with a reference to help guide their care of infected patients. To that end they have brought together a group of international authors to address important topics related to infectious diseases for the critical care practitioner.

Sepsis is a very important public health problem. It is widely acknowledged that the severe inflammatory response syndrome/severe sepsis paradigm fails to stratify sepsis patients adequately. This book reviews in detail how sepsis should be managed on the basis of a novel approach to staging. The PIRO (predisposing factors, infection, response, organ dysfunction) model was first proposed at the start of the decade on a theoretical basis and has now been translated into a practical approach for use at the bedside. It is loosely based on the TNM staging system for cancers, with points being allocated to each of the four aforementioned key characteristics of the septic process. The proposed PIRO framework facilitates evaluation of factors that are important in the pathogenesis of severe sepsis and in the development of treatment strategies. This book clearly explains the advantages of the PIRO approach in different settings and will be of value to all practitioners concerned with the management of sepsis.