Shock and the Adult Respiratory Distress Syndrome

1. Front Matter

   Pages i-xv

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2. The Morphology and Pathogenesis of Acute Lung Injury

   1. Front Matter

      Pages 1-1

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   2. Fluid Flux Across the Microvascular Endothelium

      • J. Gamble

      Pages 3-19

   3. The Morphology of the Adult Respiratory Distress Syndrome

      • G. Schlag, H. Redl

      Pages 21-31

   4. Mediators in Acute Lung Injury: The Whole Body Inflammatory Response Hypothesis

      • S. Westaby

      Pages 33-41

   5. Intravascular Microaggregates and Pulmonary Embolization in Shock and Surgery

      • C. N. McCollum, K. R. Poskitt

      Pages 43-64

3. Pathophysiology of Septic Shock and the Adult Respiratory Distress Syndrome

   1. Front Matter

      Pages 65-65

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   2. Biochemical Changes in Patients at Risk from the Adult Respiratory Distress Syndrome: Does the Pancreas Play a Role?

      • M. Lamy, M. E. Faymonville, A. Adam, G. Deby-Dupont, L. Bodson, P. Damas et al.

      Pages 67-77

   3. Changing Haemodynamic Concepts in Human Septic Shock

      • L. G. Thijs, A. B. J. Groeneveld, A. J. Schneider

      Pages 79-93

   4. Oxygen Delivery and Consumption in the Critically Ill: Their Relation to the Development of Multiple Organ Failure

      • D. Bihari

      Pages 95-121

   5. Right Ventricular Performance and Positive End-Expiratory Pressure Ventilation

      • H. Forst, J. Racenberg, K. Peter, K. Messmer

      Pages 123-136

4. Some Aspects of Ventilatory Support

   1. Front Matter

      Pages 137-137

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   2. The Physiological Basis of Ventilatory and Respiratory Support

      • W. Kox

      Pages 139-152

   3. The Arterial-Alveolar Nitrogen Difference for the Assessment of Ventilation-Perfusion Mismatch

      • P. Radermacher, K. J. Falke

      Pages 153-156

   4. High-frequency Ventilation: A Step Towards “Compliance-Independent” Ventilation

      • P. P. Lunkenheimer, W. F. Whimster, N. Stroh, J. Theissen, G. Frieling, H. Van Aken

      Pages 157-166

   5. Extracorporeal Support in Acute Respiratory Failure

      • L. Gattinoni, A. Pesenti, R. Marcolin, D. Mascheroni, R. Fumagalli, A. Riboni et al.

      Pages 167-176

5. Some Aspects of Cardiovascular Support

   1. Front Matter

      Pages 177-177

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   2. The Role of Fluid Replacement in Acute Endotoxin Shock

      • U. Kreimeier, Zh. Yang, K. Messmer

      Pages 179-190

   3. Optimal use of Vasoactive Agents in Septic Shock

      • J. L. Vincent

      Pages 191-196

   4. Mechanical Assistance in the Treatment of Shock

      • C. A. Marshall, W. Kox

      Pages 197-205

The interrelated syndromes of shock and the adult respiratory distress to attract the attention of both clinical and syndrome (ARDS) continue laboratory scientists. This reflects both the size of the problem and its unresponsiveness to current lines of treatment. Doubtless, a greater appreciation of the underlying pathophysiological disturbances during the past two decades has led to appropriate action and increased survival in the early stages but once established these syndromes have remained remarkably immune to a wide spectrum of therapeutic modalities. This observation stresses the importance of prevention but also indicates the need for continued research into the nature of the established syndromes and the means whereby they may be reversed. Drs Kox and Bihari are to be congratulated on bringing together within the covers of this volume many of the acknowledged European experts in these two fields of investigation. Each author has provided an up-to-date account of his current experimental and clinical research, and their com­ bined contributions makes fascinating reading. Undoubtedly, these are exciting times in the development of understanding of shock and ARDS. Inevitably, more questions are raised than answers provided, but the accumulated knowledge presented here adds significantly to our under­ standing of this complex biological jigsaw. From this corporate endeavour will come the clinically useful developments of the future and with them the ultimate hope that the term 'refractory' shock may be finally removed from our vocabulary.

• Acute respiratory distress syndrome (ARDS)
• artery
• breathing
• cardiovascular
• endothelium
• intensive care
• intensive care unit
• management
• morphology
• pathophysiology
• physiology
• research
• respiratory failure
• shock
• surgery

• Department of Anaesthesia, Charing Cross and Westminster Medical School, London, England

  Wolfgang Kox

• Charing Cross Hospital, London, England

  Wolfgang Kox

• Department of Medicine, The Middlesex Hospital Medical School, London, England

  David Bihari

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