James C. Eisenach, M.D., Editor.

Critical Care Management Case Studies: Tricks and Traps. By G. R. Park and M. R. Pinsky. London, W.B. Saunders Company, Ltd., 1997. Pages: 304. Price:$29.95.

This book, although modest in cost and size, provides a nice overview of the field of critical care medicine using a case study format. The authors have positioned this textbook nicely between encyclopedic references and brief “clinical pearls”-type monographs. The main body of the textbook is approximately 275 pages. It is divided into 11 main sections, in which 3–6 case-oriented topics related to each section are presented. The case histories illustrate key principles related to the main section topic. Each clinical case history is followed by one or more clinical “traps,” which are designed to indicate potential pitfalls that can occur in the management of the specific case under discussion. The traps are then followed by “tricks,” which explore the conceptual framework that is used to correctly manage the clinical scenario presented in the case discussion. Each section concludes with a clinical follow-up evaluation of the case that was originally presented, highlighting the importance of both initial steps that were undertaken in the treatment of the patient and the results of the therapies that were initiated.

Although this textbook is clearly not designed to give complete coverage of the entire field of critical care medicine, it nevertheless succeeds in providing an extremely interesting overview of many of the important topics in this diverse area of clinical practice. The case-oriented format offers an interesting conceptual framework for integrating the clinical principles that are illustrated by the “traps” and “tricks.” Because each of the cases presented within a given section is only three to six pages in length, residents, fellows, or medical students on a critical care rotation would be able to use the textbook for reading during even brief periods of time. The 51 typical cases presented in this book could easily be read during the course of a clinical rotation. In addition, the book could also prove useful to clinicians preparing for subspecialty examinations in critical care. The case format provides a ready framework for identifying areas of weakness that require further review in more detailed reference works.

A shortcoming of the book is its focus primarily on medical intensive care topics. There is little if any coverage of topics specifically related to surgical critical care. Also, the cases focus mainly on issues related to the initial treatment of patients when they arrive in the intensive care unit, thus avoiding any discussion of problems associated with prolonged intensive care unit admissions. It should be noted that these are relatively minor deficiencies. More complete coverage of the field of critical care medicine or a more exhaustive examination of issues related to problems associated with long-term intensive care management would have made the book overly long and thus potentially less useful to the audiences targeted by the authors. As it is, this text should fill an important niche in the medical literature. Students of critical care medicine, regardless of their level of training, should find it useful whether it represents their initial introduction to the field or serves as a handy refresher when preparing for subspecialty examinations.

Phillip E. Scuderi, M.D.

Associate Professor of Anesthesiology; Department of Anesthesiology; Wake Forest University School of Medicine; Winston-Salem, North Carolina 27157–1009