Delirium in Critical Care, written by Drs. Valerie Page and E. Wesley Ely, two of the leading experts in the field, is a timely and welcome addition to the discussion of this diagnosis, which is extremely troublesome for both physicians and patients alike. One of the most powerful elements of this text is the patient testimony following the forward by David K. Menon. In this very moving opening statement, one can clearly see the burden delirium places on the patient and the value of such a text. Fortunately for the reader, this text offers ample information and advice on how to handle such a difficult, and sometimes elusive, diagnosis.
The book is divided into 12 very easy-to-read chapters. Although there is certainly some redundancy between the chapters, each can stand alone and offers valuable information. The book starts with a discussion, answering the question, “What is delirium in critical care?” The authors provide the reader with the history of the disorder, definitions of delirium, and finally, some advices on ways to categorize delirium, which may have implications for outcome. The text then proceeds to a very important discussion of what delirium looks like in the intensive care unit, a topic with which every intensivist should be familiar. The chapters that follow are all enlightening, providing insights into why recognizing delirium is imperative, risk factors for delirium, and how it is diagnosed.
The final chapters focus on the prevention and treatment of delirium in the intensive care unit, restraints, and end of life care. We found these chapters to be extremely valuable. However, they are brief and may leave the reader wanting a more thorough discussion. Although at times one wonders why these chapters were not combined into a more comprehensive discussion, readers of all levels will certainly find them informative.
Overall, this is an extremely easy-to-read text on one of the most pressing issues facing intensivists today. The strengths of the book lie in its simplicity, clarity, and powerful use of patient testimonies and brief cases to underscore the importance of the topics discussed. Although more references would have been nice, the authors have provided the reader with “further reading” suggestions at the end of each chapter, which complement the text very well. We applaud the authors for writing such a “user friendly,” interesting, and instructive text on this important topic. We strongly recommend this text to anyone who cares for critically ill patients and is looking for clear guidance on the diagnosis, prevention, and treatment of delirium.