ABSTRACT
The capacity of surgical patients to withstand surgery and any complications depends on their age, underlying disease process and any co-existing illnesses. Once surgical patients develop multiple organ failure (and hence require intensive care unit [ICU] support), overall mortality can be around 50%. It is clear, therefore, that detecting and treating problems before this stage is reached is much the preferable course of action. Unfortunately, critical surgical illness can often be detected easily only once a relatively advanced stage has been reached. The challenge for all surgeons who deal with patients who may become critically ill is to develop a system of practice which will allow the identification and correction of complications at the earliest stage. Improvements can be achieved through three mechanisms as summarised in Table 1.2.
