The care of critically ill patients requires a thorough understanding of pathophysiology and is centered initially on resuscitation of patients at extremes of physiologic deterioration. This resuscitation is often fast-paced and occurs early without a detailed awareness of the patients chronic medical problems. While physiologic stabilization is taking place, intensivists attempt to gather important background medical information to supplement the real-time assessment of the patients current physiologic conditions. Numerous tools are available to assist intensivists in the accurate assessment of pathophysiology and management to incipient organ failure, offering a window of opportunity for diagnosing and treating underlying disease(s) in a stabilized patient. Indeed, the use of invasive interventions such as mechanical ventilation and renal replacement therapy is commonplace in the intensive care unit. An appreciation of the risks and benefits of such aggressive and often invasive interventions is vital to assure an optimal patient outcome. The need for a multidimensional approach to the minimization of error and the consequent improvement in the clinical and economical effectiveness of an ICU is becoming increasingly clear, also. Nonetheless, intensivists must recognize when patients chances for recovery are remote or impossible and counsel and comfort dying patients and their significant others.

Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2014