Advances in Critical Care -- Effects of body position on ventilation/perfusion matching -- Chest pain -- The electrocardiogram in the emergency department -- The use of imaging to resolve difficult diagnoses -- Assessment of pain -- Titration of opioids for acute pain management -- Neonatal Mechanical Ventilation -- Extracorporeal circulation in the intensive care unit -- Clinical decision-making in the management of sepsis and septic shock -- Intracranial haemorrhage: the solution offered by recombinant factor VIIa -- An introduction to Open Source software licensing and use in anaesthesia department -- Microdialysis -- Lessons we have learnt from microdialysis in animals and humans -- Secondary brain injury — does microdialysis have a role? -- Liver graft monitoring with intrahepatic microdialysis -- Myocardial metabolism during open heart surgery, assessed with microdialysis -- Clinical Pharmacology -- The journey of a drug to the target site: what is decisive? -- The pharmacokinetics and pharmacodynamics of antimicrobial agents in intensive care unit patients as assessed by microdialysis -- Perioperative Medicine -- Anaesthetic effects on regional cerebral blood flow and metabolism: three contemporary reasons to care -- Why and when is inhalation anaesthesia better -- Analysis and instrumentations for estimating cerebral activity -- Neuroimaging pharmacology of attention and memory -- Intracranial pressure monitoring -- Improving quality of recovery -- Lung and Artificial Ventilation -- Molecular biology and lung disease What is the impact? -- Surfactant metabolism: factors affecting lipid uptake in vivo and in vitro -- Respiratory mechanics at the bedside -- PEEP and cardiac output -- Expiratory flow limitation and intrinsic PEEP -- Mechanical ventilation strategies for lung protection -- Recruitment and oxygenation -- Lung oedema in acute lung injury -- Grading severity of respiratory dysfunction, clinical correlates and indications for mechanical ventilation -- Weaning as a cardiac stress test -- Respiratory management in obese patients -- Is the acute respiratory distress syndrome a systemic disease? -- Cardiovascular Critical Care -- Invasive versus non-invasive haemodynamic monitoring in major vascular surgery -- Analysis of arterial pulse — clinical implications -- Beat-by-beat monitoring of cardiac output with pressure recording analytical method -- Haemodynamic standardisation procedures in high-risk surgery -- From Frank-Starling relationships to ventriculo-arterial coupling -- Pharmacology and selection of inotropic therapy -- Decision-making in critical care: Cardiac arrhythmias and related topics -- Management for the patient with an implanted cardiac rhythm management device -- Hypothermia in cardiac surgery -- Cardiopulmonary Resuscitation -- Pharmacological management of cardiopulmonary resuscitation -- Myocardial preservation, reperfusion injury, and postresuscitation myocardial dysfunction -- Microcirculation and Shock -- Regional blood flow distribution in septic, cardiogenic and haemorrhagic shock -- Orthogonal polarisation spectral imaging: principles, techniques, human studies -- Carbon dioxide monitoring to evaluate cell oxygenation -- The microcirculation in distress; monitoring and recruitment -- Tissue metabolism in different types of shock -- Organ dysfunction in circulatory shock — altered perfusion, metabolism or tight junctions? Do we need a shift of paradigm? -- Haemodynamic support of paediatric patients in septic shock -- Paediatric Critical Care -- Recent advances in artificial ventilation in paediatric age -- Complications in paediatric regional anaesthesia -- Home ventilation in paediatric patients with chronic respiratory failure -- Decision-making in paediatric extracranial trauma -- Developments in the treatment of postoperative pain in paediatrics -- Trauma and Emergency System -- Prehospital care: triage and primary survey -- Spine and spinal cord trauma -- Treatment of acute pneumothorax in the field -- Clinical Study Design -- Critical appraisal skills -- Literature search -- Study design.In modern medicine the most functional methodologies are taking an increasing importance in spreading informations, rendering it credible while at the same time using reliable data to focus interaction between basic science and clinical medicine. Critical care medicine embraces these needs and more than any other discipline thrives and develops thanks to interdisciplinary contact. APICE 2004 has been organised to provide precise answers to these issues. In particular, considerable emphasis has been given to the reviews regarding the most important aspects - or the most significant clinical developments - in the sectors involving variety of functions: neurological, respiratory and cardiovascular, gastrointestinal, metabolism and perfusion; trauma infections, sepsis and organ failure; perioperative medicine and life support techniques; information technology dedicated to clinical medicine, but also as a means of information and education. The contributing authors are all part of leading research groups at the international level in the various sectors presented in the volume.