The ESC Textbook of Intensive and Acute Cardiovascular Care is the official textbook of the Acute Cardiovascular Care Association (ACVC) of the ESC. Cardiovascular diseases (CVDs) are a major cause of premature death worldwide and a cause of loss of disability-adjusted life years. For most types of CVD early diagnosis and intervention are independent drivers of patient outcome. Clinicians must be properly trained and centres appropriately equipped in order to deal with these critically ill cardiac patients. This new updated edition of the textbook continues to comprehensively approach all the different issues relating to intensive and acute cardiovascular care and addresses all those involved in intensive and acute cardiac care, not only cardiologists but also critical care specialists, emergency physicians and healthcare professionals. The chapters cover the various acute cardiovascular diseases that need high quality intensive treatment as well as organisational issues, cooperation among professionals, and interaction with other specialities in medicine. SECTION 1 focusses on the definition, structure, organisation and function of ICCU's, ethical issues and quality of care. SECTION 2 addresses the pre-hospital and immediate in-hospital (ED) emergency cardiac care. SECTIONS 3-5 discuss patient monitoring, diagnosis and specific procedures. Acute coronary syndromes (ACS), acute decompensated heart failure (ADHF), and serious arrhythmias form SECTIONS 6-8. The main other cardiovascular acute conditions are grouped in SECTION 9. Finally SECTION 10 is dedicated to the many concomitant acute non-cardiovascular conditions that contribute to the patients' case mix in ICCU. This edition includes new chapters such as low cardiac output states and cardiogenic shock, and pacemaker and ICDs: troubleshooting and chapters have been extensively revised. Purchasers of the print edition will also receive an access code to access the online version of the textbook which includes additional figures, tables, and videos to better to better illustrate diagnostic and therapeutic techniques and procedures in IACC. The third edition of the ESC Textbook of Intensive and Acute Cardiovascular Care will establish a common basis of knowledge and a uniform and improved quality of care across the field.

Great progress has been made since the first description of the acute respiratory distress syndrome by the Denver group in 1967 (Lancet). Although we introduced the term 'adult respiratory distress syndrome' in our second and more detailed description of the syndrome (ehest, 1971), this was probably amistake for the simple reason that children also suffer the same syndrome fo11owing acute lung insults. Today, the syndrome of acute respiratory distress in adults (ARDS) is recognized as a worldwide problem, but the prevalence of disease varies in different parts of the world. A huge amount of research has focused on the mechanisms of acute lung injury and yet the exact sequence of events and media tors in inflammatory cascade, which result in acute respiratory failure from ARDS, is not known but many possibilities exist. The definition of ARDS has been gradua11y modified in recent years and investigators around the world are now co11aborating in order to establish more uniform concepts in identification, risk factors and mechanisms of lung injury, which someday will result in improved approaches to management. Already, at least some centers are showing improved outcomes in ARDS, achieving an approximate 60% survival rate. In the past, most large series documented only about a 40% survivability taking a11 causes of ARDS. This apparent progress is likely attributable to more meticulous and disciplined care than any specific pharmacologic attack on the basic mechanism resulting in ARDS.

This book provides a concise yet comprehensive overview of pediatric acute respiratory distress syndrome (PARDS). The text reviews the emerging science behind the new PARDS definition; explores epidemiology, pathobiology, etiologies, and risk factors; reviews state-of-the-art treatment modalities and strategies; and discusses clinical outcomes. Written by experts in the field, Pediatric Acute Respiratory Distress Syndrome: A Clinical Guide is a valuable resource for clinicians and practitioners who specialize in pediatric critical care.

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.