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INTRODUCTION

The XX century will enter the history of humankind as the landmark of the onset of scientific-and-technical revolution (STR).

The use of STR achievements in medicine, in surgery in particular, has opened new opportunities to maintain and strengthen human health. But infection, operative shock, hydration disorders, endocrine-and-vegetative shifts and other functional disorders caused by operations have created certain obstacles on the way of development of surgery. Quite a new personage has appeared intended to eliminate the obstacles to achieve a therapeutic aim by surgeon exclusively with the use of aggressive methods. This personage provided patient's safety in the course of surgical operations.

Since the moment of discovery of narcosis this role, as a rule, was performed by the operating surgeon himself, giving orders to the unknown anesthetists — junior surgeon's colleagues, being free from the operation, i.e. persons being taught the surgery, medical orderlies. As the techniques of narcosis became complicated and the new personage's tasks had gone beyond the limits of simple anesthesia, his role became too much for occasional performers. A figure of the professional-anesthesiologist came to light, the representative of new speciality — anesthesiology.

A further development of surgery and anesthesiology has led to the extension of anesthesiologist's functions. He started to control, maintain and even to restore the temporarily lost vital functions of the organism, that is to perform the elements of the revivification. He became the anesthesiologist-resuscitator.

A next step in the development of anesthesiology-reanimatology became its introduction, apart from surgery, into other, traditionally conservative sections of clinical medicine — cardiology, pulmonology, endocrinology, infectious diseases, toxicology and others. Here, the task of anesthesiology-reanimatology lies not at all in anesthesia, rarely in restoration of the lost vital functions, but more often and mainly — in the prevention of the disturbance of these functions. Regardless of the branch of medicine (surgery, toxicology and others) and nosology, the patient's condition in which the present disturbances of the vitally-important physiologic functions of the organism

are not able to be corrected spontaneously by means of self-regulation and their partial correction or a complete replacement are needed, is called critical. And the process of patient's treatment being in the critical state is called an intensice care.

A doctor, carrying out the intensive care, must possess an anesthesiologist's knowledge and skills. But whether it is properly to call him anesthesiologist if he treats, for example, infectious patients, having no need in anesthesia? It is not entirely proper to call him resuscitator, as far as he is, mainly, not engaged in revivification (resuscitation), but in the intensive care. Evidently, it would be more properly to call such a physician the representative of the already formed branch of medicine — the intensive care medicine, though in Ukraine, in contrast to some other countries, such a terminology has not yet officially admitted.

This textbook sets forth the fundamental regulations of the intensive care medicine tentatively placed in three sections: anesthesiology, resuscitation and intensive care.

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