James C. Eisenach, M.D., Editor

Cardiopulmonary Critical Care, 3rd Edition. Edited by David R. Dantzker, M.D., and Steven M. Scharf, M.D., Ph.D. Philadelphia, W.B. Saunders Company, 1998. Pages: 704. Price:$125.00.

This is the third edition of a popular resource that concentrates exclusively on the cardiac, circulatory, and respiratory organ systems in critically ill patients. Unlike other texts in critical care, this book does not attempt to be all encompassing and comprehensive. Instead, this book provides brief detailed discussions of common physiologic problems encountered in the intensive care unit. This text represents a terrific blend of scientific facts and comprehensible discussion that allows for rapid retrieval of information necessary to care for critically ill patients. Each contributing author abided by the editors' premise of concise, detailed information about the selected topics.

The book is divide into three sections: pathophysiology, principles of treatment, and specific disorders. To me the best section of the book is pathophysiology. Within this section are specific chapters reviewing acute lung injury, gas exchange, pulmonary circulation, cardiac function, oxygen transport and utilization, and pulmonary mechanics. Each chapter reviews the basic physiology and then succinctly reviews the pathologic changes in this physiology that occurs in critical illness. The discussions are brief enough to maintain the reader's interest yet detailed enough to provide a framework adequate to allow a physician to care for patients within the intensive care unit. Photographs, diagrams, and tables are dispersed throughout the text to further enhance the educational value of each topic. Each chapter is laced with references to allow the reader to further research the specific topic; but it is may opinion that each chapter is detailed enough to provide an excellent review of each topic within cardiopulmonary critical care.

The authors do not hesitate to provide opinions confirmed by the medical literature. Within the section “Specific Disorders,” the book provides specific treatment algorithms based on the best available medical evidence, again providing references to confirm these opinions. This is best highlighted in the chapter regarding deep venous thrombosis and pulmonary embolism, in which the text includes discussions of diagnostic techniques, interpretation difficulties, and treatment modalities, both conservative and invasive. Included in the discussion are vena cava filters, thrombolytic therapy, embolectomy, and an excellent discussion of heparin and heparin-related compounds. Finally, there is an encompassing algorithm that provides the reader with a “checklist” of considerations for patients with thromboembolic disorders.

In summary, the third edition of Cardiopulmonary Critical Care represents one of the best texts available for the clinical application of critical care medicine. Its $125-suggested price is an excellent value, considering the depth and range of topics discussed within its pages. If you have ever said to yourself, “I wish there was a 5-min reference about this subject,” then I strongly encourage you to look at this text. Indeed, any clinician who provides care for critically ill patients should consider investing in this book.

Drew A. MacGregor, M.D.

Assistant Professor of Anesthesiology and Medicine; Wake Forest University School of Medicine; Associate Medical Director, Adult Intensive Care Unit; Wake Forest University Baptist Medical Center; Winston-Salem, North Carolina dmacg@bgsm.edu