Handbook of Critical Care. Second Edition.

Handbook of Critical Care. Second Edition.

REVIEW OF RECENT BOOKS Handbook of Critical Care. Second Edition. Edited by James L. Berk, M . D . , and James E . Sampliner, M . D . Boston, Little,...

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Handbook of Critical Care. Second Edition. Edited by James L. Berk, M . D . , and James E . Sampliner, M . D . Boston, Little, Brown, 1982 688 pp, illustrated, $24.50

Reviewed by David V . Feliciano, M . D. Since its introduction in 1976, this handbook has become one of the most popular references in the emerging field of critical care medicine. As before, the book is intended to be a source of core information as well as a practical guide to the care of patients in any adult intensive care unit, whether it be of the surgical, neurosurgical, medical, coronary care, or respiratory type. The format for this edition is similar to that of the earlier. The first 22 chapters, which include new chapters on noninvasive diagnostic techniques, oxygen administration, and critical care of the neurosurgical patient, constitute a critical care management section that covers most of the problems encountered in the intensive care unit. These chapters are comprehensive, well organized, and readable. Practical suggestions regarding the setup of monitoring equipment, use of the Swan-Ganz catheter, institution of hyperalimentation, and a rational approach to antibiotic therapy in an intensive care setting are extremely helpful to the resident in training. The chapter on oxygen administration is elegant in its simplicity and should be read by every junior house officer before entering an intensive care unit. However, the chapter on adult respiratory distress syndrome is overwhelming, and could have been simplified in a handbook of this type. Further, experienced intensivists will question the use of a fixed dose of cimetidine, the avail-


ability of sodium bicarbonate in 44 mEq ampules, the statement that 35% of patients in intensive care units are probably suffering from hypophosphatemia, or the use of soft cervical collars in the management of patients with suspected spinal cord injuries. The addition of a discussion on the use of calcium-channel blocking agents in cardiac arrhythmias and a Glasgow coma scale would have been helpful. The last seven chapters, which include new material on the monitoring of local partial oxygen tension in skeletal muscles, blood substitutes, and mass spectrometry, make up a section on recent advances in critical care medicine. These chapters are much shorter and less well referenced than the preceding ones, but they offer a good introduction to some of the highly specialized areas of critical care medicine. The presence of a chapter on use of the membrane oxygenator for refractory acute respiratory failure is of limited value in a handbook of this type, however, and a discussion of the use of small calculators and the many intensive care programs available would have been helpful to smaller intensive care units where the purchase of a computer is unlikely. Five appendixes listing normal values, formulas, nomograms, drug dosages, and conversion factors complete the book and are most helpful as a reference source. However, the lack of agreement on normal values and formulas between the chapter on shock and the appendix is somewhat disconcerting. This book is an excellent introductory text for medical students, house officers, nurses, or allied health personnel. It is comprehensive but concise, and can easily be read during a single student or resident rotation in an intensive care unit. The editors have once again accomplished their stated purpose.

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