Critical Care Update 2004 Vineet Nayyar
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1Critical Care Update 20042
3Critical Care Update 2004
Editor Vineet Nayyar MD FRACP FJFICM Staff Specialist ICU Westmead Hospital Westmead NSW 2145 Australia
4Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
EMCA House, 23/23B Ansari Road, Daryaganj
New Delhi 110 002, India
Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021, +91-11-23245672
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Critical Care Update 2004
© 2005, Vineet Nayyar
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editor and the publisher.
First Edition : 2005
9788180615054
Typeset at JPBMP typesetting unit
Printed at Lordson Publishers (P) Ltd., C 5/19 RP Bagh, Delhi-110007
5List of Contributors 7Preface
Critical Care Update is an annual publication at the end of each calendar year. Now in its fourth year of production, “The Update” has grown in all dimensions. The process involved in its planning has been extended and the depth of its coverage has also improved. To support further growth and evolution of this publication, I had hoped to constitute an editorial board last year, but events in my personal life interrupted the process. The year gone by has been eventful in more ways than one. The Science of ICU Medicine has evolved rapidly with a number of publications last year appearing in mainstream journals like the New England Journal of Medicine and JAMA. The growth of scientific interest in the specialty of Critical Care augurs well for the future.
In accordance to the pattern established last year, the first section of this book carries a series of articles that define a theme. This year, I have chosen to focus upon Critical Care Education for its relevance to the current scenario in India. As a whole, medical education stands at a difficult crossroads in India today. For although it seems easier for an individual to gain entry into a medical college, the quality of education and standards of evaluating competence have all been diluted beyond recognition. Unrestrained demand and commercial interests have driven the process into a downward spiral. Doctors, as important stakeholders of their own professional standards have either been disenfranchised or sucked into the chaos out of their own craving for personal gain. At a crucial time such as this, it appears appropriate to turn our attention to the building blocks of the future. Critical Care Education is one such element that is still luckily in the hands of professionals who can determine the course it takes in the future.
Some of you may have noticed that the editorial base of the Update has shifted from Bangalore in India to Sydney in Australia. This shift has afforded me more time to plan and edit the contents. It has also given me an opportunity to contact a large number of new contributors from around the world. At the same time, it has also posed a challenge for me to try and keep a balance between what is relevant in India and what is available in the West. All along, I have endeavored to make the contents of this book pertinent to the practice in India by inviting a major contribution from Intensivist authors in India. I have, so far, received a lot of support. This year, I have included contributions from some overseas authors that I have never even met! I am especially thankful to those who readily agreed to write for this book.
Over the last few years, the publishers M/s Jaypee Brothers Medical Publishers (P) Ltd.have provided me with extraordinary support and I sincerely hope that I am able to sustain this fruitful relationship into the future. Finally, to you the reader, I hope this update meets your expectations.
Vineet Nayyar
Sydney (Australia)
Dec 2004