Pulmonary Insufficiency and Respiratory Failure

Pulmonary Insufficiency and Respiratory Failure

REVIEW OF RECENT BOOKS PULMONARY INSUFFICIENCY AND RESPIRATORY FAILURE. By Giles F. Filley, M.D. Lea Q Febiger, Philadelphia, 1967. 162 pp., 28 illus...

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PULMONARY INSUFFICIENCY AND RESPIRATORY FAILURE. By Giles F. Filley, M.D. Lea Q Febiger, Philadelphia, 1967. 162 pp., 28 illus., $7.00.

Reviewed by Timothy Takaro, M.D. T h e author, in the preface of this small book, states that “respiratory physiology . . . has acquired such a specialized language and . . . such a narrow outlook, that much of the literature on lung function is either inaccessible or irrelevant to the clinician.” T o remedy this, he has written a lucid, concise, and readable monograph for the clinician, using simple words. This is not to say that the concepts which are presented are simple, for they are not. But they become nicely comprehensible with the help of the explanations and interpretations provided by the author. Dr. Filley divides this work into the two main parts which make u p the title of the book. In the first section, “Pulmonary Insufficiency,” the clinical characteristics of ambulatory patients with chronic pulmonary diseases causing dyspnea and chronic cough are described, and the measures taken to prevent respiratory failure are outlined. “Respiratory Failure,” in turn, is defined in terms of significant arterial hypoxemia or hypercapnia, and is dealt with in the second section. There are excellent discussions of cough, dyspnea, airway obstruction, chronic CO, retention, acute respiratory acidosis, pulmonary hypertension, pulmonary thromboembolism, cor pulmonale, etc. One of the best chapters explains current thinking about the causes and effects of hypoxemia and tissue hypoxia. Excellent diagrams and illustrations help in understanding these concepts. Chapters on the systematic study of the outpatient, on the organization and function of a respiratory care unit, and on the clinical features and management of acute respiratory failure attest to the practical slant which one finds so refreshing in this book. For those who feel the need, appendixes and footnotes contain the mathematical formulas, symbols, measurements, and technical terms which make the usual treatise in this field such formidable read388


Review of Recent Books

ing for the average physician and surgeon. Thus, one is left with a useful book by a specialist who speaks with much common sense to clinicians and in the language of clinicians. Thoracic surgeons and residents will find it particularly useful, because it is comprehensive, interesting, and practical. Oteen, N .C.

CARDIAC PACEMAKERS. By Harold Siddons, M . C h . , and Edgar Sowton, M.D. Charles C Thomas, Springfield, Ill., 1967. 221 pp., illus., $1 6.75. Reviewed b y William E. Neville, M.D.

This is an excellent treatise on the present status of electronic equipment designed to pace the heart artificially. T h e authors’ extensive experience in employing all the main methods of pacing combined with much previously unpublished information from their many colleagues in other countries makes this book a very meaningful contribution. A list of 896 references is included, and, in addition, an appendix contains the details of more than 25 pacemakers manufactured in seven countries. T h e appendix includes every unit in the world of which the authors have had knowledge. This book should be on the shelf of all thoracic surgeons and cardiologists because it is comprehensive and written in a manner which is easily understood by both the neophyte and the complete doctor. One of the many excellent chapters is that on long-term pacing, for which the indications and the methods are detailed. Of particular pertinence are the complications and failures-of interest to all involved in insertion of pacemakers because of the many trials and tribulations which can occur when using an artificial appliance. T h e last chapter is devoted to special considerations, such as pacing in acute myocardial infarction, paired pacing, and the application of biological energy for pacing. T h e authors state that patients who develop complete heart block during the course of a myocardial infarction should be artificially paced and point out that pacing occasionally may be indicated to suppress arrhythmias following coronary occlusion. T h e subject of paired pacing, which has shown considerable promise in the laboratory, has not been proved out clinically. They review this probVOL.