The surgical patient may exhibit a variety of subtle and not so subtle clues that a problem, or in the words of the authors "a hole", is present. Therefore, when evaluating and managing the critically ill patient, the critical care surgeon must proceed through a series of three questions: Where is the hole? How do I repair the hole? and the most critical question, Why is the hole there? The Clinical Handbook for Surgical Critical Care is a guide to answering these questions, bringing into focus the importance of "why is the hole there?" and exploring how to effectively make it disappear. Since much of surgical critical illness is secondary to either inadequate circulation, pathological inflammation, or both, the authors pay particular attention to the recognition of these conditions associated with particular disease states. The authors examine the pathophysiology that underlie these disease states and then the physical examination, monitoring, and laboratory results that lead to a diagnosis. They discuss appropriate management of the deranged physiology and provide the supporting evidence for treatment. The Clinical Handbook for Surgical Critical Care serves as a manual for reviewing and contrasting organ physiology during normal and pathological states and recognizing the pathophysiological states related to surgical disease and procedures. It gives you a clear understanding of the link between deficits in the circulation and pathological inflammation that is key to a successful outcome.