Oh’s Intensive Care Manual, 5th Edition, A.D. Bersten & N. Soni, Butterworth Heinmann, 2003

Abstract

Oh’s Intensive Care Manual, 5th Edition, A.D. Bersten & N. Soni, Butterworth Heinmann, 2003 Andrew D. Bersten and Neil Soni, eds. Boston: Butterworth-Heinemann (an imprint of Elsevier Science Limited), 2003. ISBN 0-7506-5184-0. 1176 pp, $79.95. The textbook market for physicians training in critical care consists principally of two categories, small pocket manuals and large encyclopedic textbooks. For some time, a medium-sized but comprehensive tome to recommend to residents and fellows has been needed. The new edition of Teik Oh’s Intensive Care Manual, which has long been the favorite text of critical care trainees outside the United States, meets this need. The new edition, edited by Andrew Bersten and Neil Soni, is written by a veritable who’s who of British and Australian intensivists. The book is divided into 100 or so medium-sized, easily digested chapters that are organized into 17 sections, covering the whole spectrum of critical care, from the design and organization of intensive care units through infections and supportive care to environmental injuries. New chapters have been added addressing topical issues such as ethics, post-ICU problems and biologic terrorism. Unlike many competing texts, Oh’s Intensive Care Manual addresses cardiac care, pediatric critical care, and obstetric emergencies. The chapter on hemodynamic monitoring is especially outstanding. One of the book’s great strengths is the coverage of broader issues in critical care, such as poisoning, hematology, trauma, hypothermia, and electrocution. The chapters on donor preparation and transplantation are particularly useful, being poorly covered elsewhere. The chapter on “envenomation” (snake bites) is especially enjoyable. The Intensive Care Manual, running at 1100 pages, is undoubtedly the most comprehensive, concise textbook of critical care medicine available. However, the structure of the book also leads to some drawbacks. The practice of intensive care medicine is dominated by shock, fluid balance, sepsis, and respiratory failure. Yet the space allocated to these problems is the same as that given to HIV and plasma exchange. We were particularly disappointed with the chapters on respiratory failure, which, like the majority of publications, describes modes of ventilation rather than ventilation strategies. Surprisingly, there is no chapter on ventilator liberation, or failed weaning, a major problem in critical care. Likewise, the neuroendocrine response to critical illness receives little mention. The lack of reference to the physiochemical (Stewart) approach to acid base balance, a highly topical subject in the critical care literature, was surprising, as was the failure to address the importance of the topical issue of ventricular interdependence and right ventricular dysfunction. These limitations, nevertheless, should not deter the reader. The book is a remarkably easy read, with chapters organized into subsections using bulleted lists and thoughtful diagrams and tables. With its soft cover the manual is highly portable, and the majority of chapters can be read in a single session. This makes the book an ideal companion for a night “on call.” In conclusion, Oh’s Intensive Care Manual is an excellent text for those who need a comprehensive review of all aspects of critical care. As a review book for the Critical Care Boards, with its size and readability, this book is peerless. While more focus on the clinical approach to critically ill patients is recommended for future editions, these reviewers will happily recommend this edition to their residents and fellows.