Handbook of Sepsis

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Editors Wiersinga and Seymour provide an aptly named Handbook of Sepsis: a compact and concise review of this common presentation. The Handbook, which can be mistaken for a novel on first glance, reads as such. It differs from the average critical care textbook with its casual inviting appearance, and yet provides a comprehensive review of multiple topics in sepsis care. The book is divided into 4 major sections, which comprise a total of 16 chapters by 36 international authors. The first of the 4 sections is an overview of sepsis, which includes a discussion of its historical and contemporary understanding, as well as a review on the epidemiological considerations. Long-recognized issues such as culture-negative sepsis are appropriately summarized. The second section focuses on important pathogenetic mechanisms, with topics including coagulopathy of sepsis, metabolic sequelae, and important biomarkers. These chapters are brief, appropriately focused, and provide an excellent overview of current understanding of these topics. The few included figures and tables were clear and complemented the text well. The majority of the book focuses on the third section: sepsis management. Chapters are devoted to topics including consensus guidelines, fluid therapy, vasopressor therapy, multiorgan failure, pathogen control, relevant antimicrobial therapy, and immunotherapy. Discussion of these management techniques includes a review of landmark studies that guide international standards of care, as well as a review of areas of academic equipoise (eg, choice of fluids for resuscitation). The final section elaborates on future directions in sepsis research and management. The authors provide the reader with a review of sepsis-specific trial design and research, considerations for low- or middle-income countries, and a brief chapter on future management trends to close (eg, precision medicine). The book has several strengths, such as a diverse authorship. These include internationally renowned thought leaders in sepsis such as Jean-Louis Vincent, Derek Angus, and Flavia Machado. Importantly, the authors have mostly contributed to chapters of which they have recognized content expertise, for example, Dr Derek Angus on trial design in sepsis research. Another strength is the balanced focus between knowledge that is immediately clinically relevant, and a basic science understanding of these principles that make the foundation of sepsis care. Ultimately, a scientific rationale for specific sepsis management therapy is center stage. This is truly where the Handbook shines: the science (from bench-to-bedside) presented is comprehensive without alienating nonmethods experts. It makes efforts to explain the science behind sepsis with chapters on clinical guidelines development as well as the previously mentioned trial designs section. While the book presents with multiple strengths, we believe that its title may not accurately depict its content. The Handbook reads very easily, however, unlike typical clinical handbooks, there is a relative deficiency of salient clinical pearls that may be applied at the bedside. These can be found embedded as nuggets of clinical nuance within the text, but having these summarized or immediately visible would be of value to the bedside clinician reading this text. Overall, this book provides the reader with the context on which sepsis care has been built, a review of current management, as well as a discussion of future trends. It would be a welcomed addition to a bookshelf of any trainee, health professional, or basic/clinical researcher who seek to immerse themselves into this complex and well-studied disease entity. It is concise and lends itself as an excellent, yet intimate, introduction into this vast topic area. Vatsal Trivedi, MDDepartment of Anesthesiology and Pain MedicineThe Ottawa HospitalUniversity of OttawaOttawa, Ontario, Canada Manoj M. Lalu, MD, PhDDepartment of Anesthesiology and Pain MedicineThe Ottawa HospitalUniversity of OttawaOttawa, Ontario, CanadaClinical Epidemiology and Regenerative Medicine ProgramsOttawa Hospital Research InstituteOttawa, Ontario, CanadaDepartment of Cellular and Molecular MedicineUniversity of OttawaOttawa, Ontario, Canada[email protected]; [email protected]