he thoroughly updated Fourth Edition of this classic critical care reference remains an unsurpassed source of definitive, authoritative guidance on adult patient care in the ICU. In 227 chapters written by eminent clinicians, the text provides comprehensive, practical coverage of every aspect of both medical and surgical intensive care. Virtually every chapter has been extensively rewritten and updated to reflect contemporary principles, protocols, and techniques. Sections related to all aspects of surgical intensive care have been expanded, and sections on shock and trauma, coronary care, neurologic problems, rheumatologic and immunologic problems, and psychiatric issues have been fundamentally rewritten. The toxicology and pharmacology sections have been combined into a 38-chapter section entitled Pharmacology, Overdoses, and Poisonings, which represents a complete ICU textbook on these topics. The popular opening section--a 30-chapter atlas of procedures and techniques--has been updated with new illustrations and descriptions of state-of-the-art techniques