Clinical Scenarios in Intensive Care. By Rona Patey and Nigel Webster. New York, Oxford University Press, 1998. Pages: 106. Price: $31.95.

This book is a collection of 21 critical care medicine case histories, each accompanied by questions and recommendations for further reading. The authors note that there are numerous volumes detailing the process of intensive care and the knowledge on which it is based, but few books with a problem-oriented presentation. They state that their book offers a "framework on which to base the practice of intensive care." The cases they present encompass common intensive care problems, such as myocardial infarction, asthma, sepsis, renal failure, and adult respiratory distress syndrome. Less commonly encountered conditions, such as tetanus, are also included. Each case is supported with hemodynamic, laboratory, and radiologic data.

This is a slim volume (106 pages) and can be read in one sitting. However, working through all the questions requires significant effort. There are a few commonly encountered intensive care problems that are not discussed (the most obvious is pulmonary embolism) and there is, in general, less emphasis on infectious disease and antibiotic therapy than is often encountered in daily practice. Nevertheless, the questions accompanying the case descriptions are comprehensive, covering diagnosis, pathophysiology, and treatment; trainees who use this book as intended by the authors will be better prepared for the practice of critical care medicine. However, those who are interested in purchasing this book need to be aware that it is by no means self-contained, nor was this intended by the authors. The book provides the cases and the questions but the reader has to provide the answers. Each chapter has references, most being review articles from the internal medicine, surgery, and anesthesiology literature, and using this book as intended will require substantial time in a library. I believe that the book would have been more useful if each question was discussed in the text so that a dialogue of questions and answers was developed for the reader. However, this would have significantly increased the size of the volume.

In summary, Clinical Scenarios in Intensive Care is a collection of commonly encountered intensive care problems with questions and references for each case. It could be a useful learning tool for trainees in critical care medicine who are willing to invest the energy needed to fully work through the questions accompanying the case reports.

James M. Bailey, M.D., Ph.D.

Associate Professor of Anesthesiology; Emory University School of Medicine; Atlanta, Georgia 30322;

(Accepted for publication February 3, 1999.)