Sepsis, kidney and multiple organ dysfunction

Severe sepsis is among the most common causes of death in the United States and the most common cause of death in the Intensive Care Units worldwide, and its recognition and treatment remain the most important challenges of critical care medicine. Severe sepsis and septic shock have a profound effect on kidney function and the function of other organs through complex mechanisms, which involve the immune response, multiple pro and anti-inflammatory pathways, intracellular dysfunction and hemodynamic instability. Their optimal management requires complex knowledge of general medicine, immunology, nephrology, extra-corporeal technology, fluid resuscitation and critical care endocrinology. In order to deliver optimal patient care, nephrologists and intensive care medicine specialists need to understand and be highly knowledgeable in the epidemiology of sepsis, the mechanisms of injury which determine outcome and the fundamental aspects of new insights into fluid resuscitation, acid-base physiology and glucose control. They also need to have a clear appreciation of new technical developments in the monitoring of critically ill patients and in the delivery of advanced extra-corporeal blood purification therapies. Experts from the fields of intensive care medicine, nephrology, endocrinology, acid-base physiology, extra-corporeal blood purification technology and immunology have contributed to the present book, providing a cutting edge view of developments in each field which contribute to the care of patients with severe sepsis, acute renal failure and multiple organ failure. The resulting mix of fundamental knowledge and recent developments from clinical trials and laboratory research constitute a valuable tool for all professionals involved in the care of the critically ill patient.