Critical Care Medicine: Principles of Diagnosis and Management in the Adult

Abstract

This impressive, 1770-page book weighs in at 3.78 kg. The weighty tome is the second edition of a text that seeks to provide an authoritative, comprehensive book aimed at practising critical care physicians. The goal was to produce the acknowledged standard in critical care medicine. While I do not understand what the goal of ‘acknowledged standard’ means in the context of a textbook, this one certainly achieves its main aims. It has a very impressive cast of authors who represent authorities in their respective fields. The layout of the book is logical with the pharmacological and technical basis of the speciality preceding the disease orientated section. The range of topics is comprehensive. It is a definitive text. The book is relatively easy to read, and is clear and concise. The sections covering practical procedures are easy to follow and informative with relevant diagrams. Where controversy exists, the pertinent arguments are mentioned and referenced but without prolonged and turgid debate. This is clearly seen in the succinct discussion about the pulmonary artery catheter, or the ‘pros’ and ‘cons’ of percutaneous tracheostomy. In fact, throughout the book, I was impressed by the clarity of the discussion that managed to address issues without losing the reader in the detail. The diagrams throughout are clear, as are the photographs and other images. The echocardiography section is particularly impressive. At the end of each chapter, there is a list of key points, some of which are very useful summaries of the chapter with some real ‘gems’, but others somewhat less informative. It is well referenced throughout and relevant papers are almost always listed. The index is easy to use and comprehensive. In general, the book is more than adequately detailed. An exception is in pharmacology where there are long lists of commonly used drugs which, in pharmacological terms, are lightweight. Clearly the intention is to provide a quick and easy guide to these drugs, not a pharmacopoeia. This is a very useful practical addition to the book but is somewhat out of kilter with the detail elsewhere. There are many outstanding chapters in this book but, in particular, the focused view of nosocomial infection is both interesting and practically relevant. Similarly, the chapter on diabetes is extremely good, as well as the discussion on ethics. It is probably unfair to highlight any individual chapters as the standard throughout is very high. Deficiencies are hard to find, but obstetrics does not really feature, and I was surprised by the lack of reference to violent injury and trauma. There are several basic questions I would ask if I was out to spend £140.00 on a textbook, which I have answered below. 1. What do I personally want it for? As a reference text'excellent. As a resource book for the intensive care unit'it is probably one of the best of its kind. As a revision textbook'probably too hard to read easily. As a manual in the intensive care unit for the problem at 02.00 h in the morning'probably too heavy, although it does have the practical information required. As one book to cover everything'it doesn't, but then none do. To look good on the book case'definitely. For bedtime reading'only if you have insomnia, but then who does read these books in bed except those taking examinations? 2. Does the intensive care unit I work in need one? Definitely. 3. Would I recommend it? Yes. 4. Would I buy one myself? Yes. 5. Is it value for money? At £37.00 per kilo it is good value. In conclusion, this is a very good textbook of critical care that would be an asset to any intensive care unit. It could be used by trainees working for examinations and by their seniors for continuing professional development or for reference. As an easy access manual, it is probably a little daunting, but would serve that function. The real test of the quality of a book is how long would it stay in the unit before it walked. The answer is, not long. This is one to secure.