Synopsis
A thorough understanding of the cardiopulmonary system is one of the foundations of critical care. In this important new text, specialists in respiratory medicine, cardiology and critical care have united to provide an authoritative, integrated presentation of the core information essential for effective patient management. Cardiopulmonary Critical Care is intended as a clinically relevant reference, not only as a study resource, but also for everyday use in the unit. The style and layout of the book reflects this, with numerous diagrams, flowcharts and checklists complementing the text and providing access to the key information. Experts discuss thoracic trauma, fluid resuscitation in the ICU, acid base disorders, oxygen transport and tissue oxygenation, acute myocardial infarction and many other topics. This book is essential for every ICU and hospital emergency room.
Reviews
This book aims to fill a niche. It is meant not for critical care specialists but rather for clinicians with intermittent responsibilities in the care of critically ill patients: internists and hospitalists, as well as trainees and students. But the book can also serve as a teaching guide and a quick reference for specialists. All the chapters are well written, and as a whole the book covers most topics in cardiopulmonary critical care with the depth and breadth often seen only in larger textbooks. To achieve their goals, the contributing authors provide concrete, consensus-based answers without delving into controversial issues. Most of the chapters are concise and are enhanced by the generous use of tables, graphs, and illustrations. Some of the illustrations are too elaborate and attempt to cover too much material. The legends, however, help guide the reader through some of the mazes. To cover all the important topics concisely, the editors had to be very selective. I expected a book filled with guidelines and a how-to approach but was pleasantly surprised by the first two chapters, which cover respiratory and cardiac physiology. The physiological background provided in several chapters is a sorely needed component for trainees. The discussion of pathophysiology varied among the chapters but overall was sufficient for the needs of nonspecialists. Some of the chapters stand out. I particularly admire the chapters by Kacmarek and the superbly detailed chapter on techniques for vascular access (chapter 23). I also like the inclusion of chapters on trauma and on the postoperative care of patients who have undergone thoracic surgery. For the most part, the chapters are up to date, but there are occasional substantive omissions. For example, the authors fail to mention recent advances in noninvasive ventilation in immunocompromised patients. Although each chapter stands solidly by itself, more cross-referencing would have consolidated overlapping information and minimized repetition. For instance, a discussion of the use of pressure assist-control ventilation to improve dyssynchrony in patients receiving pressure support could have referred to a relevant figure in another chapter, and a discussion on noninvasive positive-pressure ventilation in chapter 17 could have referred the reader to the more thorough treatment of the subject in chapter 19. "Does the world need another critical care textbook?" This is the question asked by Higgins, in the introduction. I do not know what the world needs, but I do know that this book will be valuable to clinicians. Its occasional shortcomings do not detract from its merit. I have already applied some of the information in it to the care of my patients. M. Safwan Badr, M.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
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