By A. Gullo
Developing sectors within the extensive care box - and in severe care drugs as a rule - require particular degrees of competence having a similar universal denominator: an in-depth wisdom of human pathophysiology. even if this quantity provides lots of subject matters in consistent evolution, as witnessed by means of the gathering of chapters compiled by means of numerous researchers, this variation contains, particularly, fields during which choice making on the patient’s bedside prevails over theoretical argumentation. In different phrases, the 1st and optimum message this version desires to supply is for the reader to concentration his/her recognition on evidence-based medicine.
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Extra resources for Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.: Proceedings of the 21st Postgraduate Course in Critical Medicine: Venice-Mestre, Italy - November 10-13, 2006
Science 265:2037–2048 2. Nonas SA, Finigan JH, Gao L et al (2005) Functional genomic insights into acute lung injury: role of ventilators and mechanical stress. Proc Am Thorac Soc 2:188–194 3. Ye SQ, Simon BA, Maloney JP et al (2005) Pre-B-cell colony-enhancing factor as a potential novel biomarker in acute lung injury. Am J Respir Crit Care Med 171:361–370 4. Sadikot RT, Han W, Everhart MB et al (2003) Selective I kappa B kinase expression in airway epithelium generates neutrophilic lung inflammation.
Smookler DS, Mohammed FF, Kassiri Z et al (2006) Tissue inhibitor of metalloprotei- Genetics and molecular biology in acute lung injury 17 nase 3 regulates TNF-dependent systemic inflammation. J Immunol 176:721–725 8. Bernhagen J, Calandra T, Mitchell RA et al (1993) MIF is a pituitary-derived cytokine that potentiates lethal endotoxaemia. Nature 365:756–759 9. Donnelly SC, Haslett C, Reid PT et al (1997) Regulatory role for macrophage migration inhibitory factor in acute respiratory distress syndrome.
Airway closure implies opening and closing of peripheral airways during tidal breathing and development of shear stresses that can damage peripheral airways [25, 26]. Moreover, in the presence of airway closure there is heterogeneous lung filling and emptying, which probably also contribute to lung injury [2, 15, 16]. On the other hand, the reduction of FRC with the concomitant reduction of expiratory flow reserve that is associated with anaesthesia-paralysis , abdominal surgery  or various diseases such as ARDS and obesity is expected to promote development of EFL during tidal breathing [13–16].
Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.: Proceedings of the 21st Postgraduate Course in Critical Medicine: Venice-Mestre, Italy - November 10-13, 2006 by A. Gullo