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Core cases in critical care
  1. P Nee

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    Edited by S Ridley, G Smith, A Batchelor. London: Greenwich Medical Media, 2003, £29.50, pp 250. ISBN 1-84110-161-3

    In 230 pages and a few monochrome illustrations this paperback covers the top 20 clinical cases that are the stock in trade of every intensive care unit. The authorship is a reassuring collection of UK intensivists, a who’s who? of the Intensive Care Society. I liked the standardised format; case histories are followed by discussion of the main issues with reference to pathophysiology, treatment options, and outcome. A panel of key learning points rounds off each chapter, and the recommended further reading is appropriate and proportionate.

    A number of the cases bear upon emergency care and many are set in the resuscitation room. The importance of securing the ABCs is emphasised before discussion of theoretical concepts, not always the case in books of this sort. This reflects the interests of the authors, many of whom are active in education at the interface between intensive care and emergency medicine. Relevant cases include burns, trauma, and overdose, but pyrexia is included uncomfortably in the chapter on status epilepticus. The chapters are up to date; the roles of inhaled nitric oxide and prostacyclin in ARDS are set out. And there is a review of the evidence on non-invasive ventilation in COPD. Activated protein C is (to this reviewer at least) a very new treatment in septic shock, and its brief mention is testimony to the book’s contemporary quality. The Swan Ganz catheter is placed in its correct context, alongside alternatives including the pulse induced continuous cardiac output monitor. I was also pleased to see the role of corticosteroids set out in accordance with current thinking on the treatment of sepsis.

    This reviewer has an aversion to diagrammatic representation of pulmonary physiology, lung capacities, closing volumes, and zones of perfusion. The authors avoid such esoteric concepts, and there is no assumption of knowledge of molecular biology in the chapter on sepsis and multiple organ failure. Cardiac care is the major omission from what is otherwise a reasonably broad based content.

    Trainees in intensive care medicine from all parent specialties will find this a useful and accessible resource. It sets out to present a consensus approach to common clinical problems, and is not a comprehensive textbook. For any specialist registrar about to start a secondment in the ICU this little book would be a good investment.

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