Management Of Dysregulated Immune Response In The Critically Ill

This book, part of the European Society of Intensive Care Medicine (ESICM) textbook series, deals with dysregulated host response a relatively new term introduced by the Sepsis-3 definitions in 2016. In contrast to systemic inflammatory response syndrome (SIRS) that has been used for nearly 30 years, this is a fundamentally new concept, which requires some sort of a paradigm shift in the way of thinking of critical care physicians. This change obviously requires time and after 5 years, time is ripe to summarize the knowledge in the form of a comprehensive book. The book is split in 4 sections. In the first one, the host immune response is explained in 11 chapters, followed by the next part, summarizing the possible tools for assessment at the bedside. The third and the fourth parts focus on the effects of dysregulated immune response on vital organ function and on the possible ways of immunomodulation. Written by internationally acclaimed experts of the field, the book is of value for all those intensivists and allied professionals working in ICUs.

This book brings together basic scientists or clinicians from a variety of different backgrounds - immunology, infectious diseases or critical care - who share a common interest in understanding the changes that occur in immune responses in sepsis. It provides an up-to-date and unrivalled synthesis of current research in this rapidly developing field.

This book, part of the European Society of Intensive Care Medicine textbook series, provides detailed up-to-date information on the physical, cognitive, and psychological impairments that are frequently present following a stay in an intensive care unit and examines in depth the available preventive and therapeutic strategies, including adapted rehabilitation programs. Beyond acquainting readers with the multiple facets of post-intensive care syndrome (PICS), the book aims to promote the effective follow-up of patients, thereby enhancing their ability to work and their functional autonomy, and to identify risk factors for the development of PICS as a stimulus to beneficial organizational changes in intensive care departments. The background to the book is the realization by healthcare providers that the quality of life of patients who have required a stay in an intensive care unit can be severely impaired or even become unacceptable. All too often, the diverse sequelae are overlooked by specialists of other disciplines. Moreover, families and caregivers are also at high risk of post-traumatic stress disorder and depression. 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, written by renowned experts in the field, will facilitate the transmission of key knowledge with significant clinical and financial benefits.

This book explains how stress – either psychological or physical – can activate and/or paralyse human innate or adaptive immunity. Adequate immunity is crucial for maintaining health, both on Earth and in space. During space flight, human physiology is specifically challenged by complex environmental stressors, which are most pronounced during lunar or interplanetary missions. Adopting an interdisciplinary approach, the book identifies the impact of these stressors – the space exposome – on immunity as a result of (dys-)functions of specific cells, organs and organ networks. These conditions (e.g. gravitation changes, radiation, isolation/confinement) affect immunity, but at the same time provide insights that may help to prevent, diagnose and address immune-related health alterations. Written by experts from academia, space agencies and industry, the book is a valuable resource for professionals, researchers and students in the field of medicine, biology and technology. The chapters “The Impact of Everyday Stressors on the Immune System and Health”, “Stress and Radiation Responsiveness” and “Assessment of Radiosensitivity and Biomonitoring of Exposure to Space adiation” are available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.

This book describes the issues and challenges that clinicians encountered in the management of older critically ill patients during the Covid-19 pandemic, and offers practical information on how to manage them. Older adults are more susceptible to complications such as acute respiratory distress syndrome (ARDS) as a result of viral pneumonia. In addition, they often have multiple comorbidities and are commonly frail, which means their various organs and systems, such as the respiratory system, have reduced functional reserves. As such, older adults are less able to react to acute stressors. During the current Covid-19 pandemic, older adult patients' mortality is increased. Further, the infection and death rates of elderly people in nursing homes and health care institutions are high. Management of older adults with Covid is complicated. The reduced availability of beds may limit their access to ICU. Moreover, the prognosis may be poor, and airway management and ventilation strategies have to take into account various clinical and physiological characteristics specific to older patients. This book is addressed to all allied professionals involved in the management of older critically ill patients and presents information collected and practical lessons learned from the clinical daily management of this population during the pandemic.

This book, part of the European Society of Intensive Care Medicine (ESICM) textbook series, provides detailed up-to-date information on the care of the critical ill very old (≥80 years) patients in the ICU. The very old are expanding fast in our populations, and this is mirrored in our hospitals and ICUs as well. During the last decade, a lot more information about the group of critical ill elderly has been published, and several large networks cooperate in performing multinational studies in this field, one of them with roots in the ESICM. This book will give readers knowledge about the current epidemiology of elderly ICU patients, in patients centered outcomes and factors affecting these outcomes. A large part is devoted to age related changes in vital organ functions, and the specific geriatric “syndromes” like frailty, cognitive decline, reduced activity of daily living, sarcopenia and immunosenecence. This is all important for the practicing intensivists to know about. In addition, specific groups of the elderly in the ICU are also described like the elderly patients with trauma or sepsis. The book is written jointly by intensivists and geriatricians, often working in teams and originating from many different countries. This herald a new era in the collaboration between these two groups in order to improve care and rehabilitation. We have a lot to learn from each other, as both groups have a holistic view of our patients although with different perspectives. This book should be of value for all working in adult ICUs, physicians as well as nurses. It will hopefully lead to a better understanding of the particular challenges posed by this important sub-group of ICU patients and how to manage his group in a way that combine respect for life as well as death and includes patients and caregivers in this process.

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 designed to offer the reader first-rate guidance on shock management in the real world. Comprehensive, evidence-based, and up-to-date instruction is provided on optimal care of patients with different types of shock – septic, hemorrhagic, cardiogenic, anaphylactic, and obstructive – at all stages from initial response through to ICU admission. As well as management, the coverage encompasses pathophysiology, clinical presentation, diagnosis, and emerging trends. A further key feature is the use of a scenario-based approach to present a series of cases based on real-life experiences. Here, a narrative style and Q&A form are employed to vividly convey scenarios that may be encountered in clinical practice and to elucidate decision making in complex circumstances. When readers experience difficulty in answering the questions, the earlier sections can be consulted to identify the correct response. This book will be of great value for all health care professionals. In particular, it will be very helpful for novice or inexperienced practitioners in emergency medicine, critical care medicine, and traumatology.