Textbook of Critical Care, 3rd edition.

Abstract

Textbook of Critical Care, 3rd edition. Eds W. C. SHOEMAKER, S. M. AYRES, A. GENVIK and P. R. HOLBROOK. W. B. Saunders, 1995. Price £84.00, pp. 1892. With over 300 contributors and 17 sections divided into 205 chapters, this is a truly mammoth multi-author, multi-disciplinary comprehensive critical care medicine textbook. Its role lies somewhere between an encyclopaedia of critical care and a collection of topical reviews and articles by authorities from institutions throughout the USA and some contributors from the rest of the world. The style of the book is by and large fairly uniform with a mixture of descriptive text, tables, figures and a number of clinical algorithms and guidelines. In comparison with the second edition there appears to have been more thought given to the organisation of the various sections. A new introductory section contains chapters on the history of the subject, and design and planning of a unit. An entirely new section on cell injury and cell death recognizes the explosion of interest in the role of free radicals, cytokines, arachidonic acid by-products and other factors in acute illness. A new section on imaging provides useful articles on developments such as the use of ultrasound, abdominal CT scanning, transoesophageal echocardiography and interventional radiology in the diagnosis and management of critical illness. Included in these chapters are high quality black and white and colour plates of appropriate scans. The section on transplantation has been considerably expanded to include separate chapters on transplantation of all major organs, organ procurement, immuno-suppression and complications in transplant patients. The substantial sections on cardiovascular and pulmonary topics have been updated with chapters on the heart in sepsis, pacemakers and implantable defibrillators, respiratory muscle failure in critical illness, surfactant therapy and extracorporeal and intravascular gas exchange devices in addition to the more standard topics. The section on abdominal organ dysfunction contains discussions on hepatic, renal, pancreatic and gastrointestinal disorders and management thereof, although adrenal dysfunction is found in the section on metabolism and pharmacology. There are other possibly anomalous classifications such as hyperpyrexia in the trauma section. Closer examination of some of the contents reveals some omissions, for instance no mention of the usefulness of amiodarone in the treatment of tachydysrhythmias in the critically ill, very little about pressure control ventilation and only a relatively brief discussion of malignant hyperpyrexia. Other particularly useful articles are those concerning anaesthesia and the high-risk patient, intra-operative haemostasis, transfusion therapy and acute pain in the intensive care unit; all these are found in section 12 on trauma. The final three sections address nursing issues in patient care, organization and management, and ethical decision making in critical illness. Although the book does not contain a separate paediatric section, most sections have one or two chapters on paediatric aspects. This is an extremely comprehensive book. A significant number of the references quoted are from the last 1-5 years and much of the treatment discussed is innovative. There are inevitable overlaps in topics which the editors regard as valuable in giving differing insights into topics. It is not the easiest book to read, a feature of such a wide-ranging multiauthor approach. It does, however, provide so much information and so many recent references that it should be regarded as a standard critical care textbook and should be included in the 'unit' library. R. M. SLATER Manchester