Reviews of Educational Material  |   July 2007
Clinical Critical Care Medicine (textbook and CD-ROM).
Author Notes
  • David O. Warner, M.D., served as Section Editor for this review.
    David O. Warner, M.D., served as Section Editor for this review.×
    (Accepted for publication December 5, 2006.)
    (Accepted for publication December 5, 2006.)×
Article Information
Reviews of Educational Material / Critical Care
Reviews of Educational Material   |   July 2007
Clinical Critical Care Medicine (textbook and CD-ROM).
Anesthesiology 7 2007, Vol.107, 183. doi:10.1097/01.anes.0000268277.30436.69
Anesthesiology 7 2007, Vol.107, 183. doi:10.1097/01.anes.0000268277.30436.69
Clinical Critical Care Medicine (textbook and CD-ROM). Edited by Richard K. Albert, M.D., Arthur Slutsky, M.D., Marco Ranieri, M.D., Jukka Takala, M.D., Ph.D., and Antoni Torres, M.D. Philadelphia, Mosby-Elsevier, 2006. Pages: 722. Price: $139.00.
Emulating a film critic's approach to commentary, the reviewers supply two thumbs up for Clinical Critical Care Medicine, a beautifully illustrated, first edition, internationally multiauthored textbook. These impressions represent the thoughts of a neuroplastically facile, recently certified, intensive care unit (ICU) attending trained in medicine, pulmonary, and critical care who is currently completing an anesthesiology residency, complemented by those of a gray-bearded, balding senior attending who remains active as an intensivist, internist, and anesthesiologist. The senior reviewer also has coedited two multiauthored Critical Care Medicine textbooks, appreciates what an undertaking that is, and has had the pleasure of contributing to or reviewing several other ICU books.
We base our humble opinions on visual assessment, weight, format, readability, and utility of addressing important concepts as well as securing commonly accepted factual knowledge. Like any text, this one has a few deficiencies, but it packs a tremendous amount of information and expertise into a fairly modest sized package that will not deplete mitochondrial adenosine triphosphate stores when it is pulled from the shelf or carried from an office. The utility of the book was tested further by the first author reading it as part of her preparation for board certification while the other reviewer did the same as part of his maintenance of certification program.
Visually, this is a pleasing and impressive book that supplies a plethora of highly informative pictures, radiographs, tables, graphs, boxes, diagrams, and flowcharts. There is often more information contained within the visual assets than in the text. Chapters are well edited, easily read, and formatted in a fairly consistent manner, given the voice of more than 110 authors who represent a multidisciplinary view of critical care practitioners that is almost universal, lacking mainly in representation from the continent of Antarctica and medical centers north of the Arctic Circle. Each chapter starts with a Key Points introduction that highlights features and take-away points contained in the chapter. Chapters are modestly referenced using a suggested reading format. References seem to be readily available and for the most part timely, although it is always a challenge to remain up to date. The book has a publication date of 2006, but there are no references later than 2004 and few beyond 2002. Therefore, several recent sentinel pieces such as the American Thoracic Society's position paper on “Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia” are not included or were not available at the time of production.1 
The textbook is a “tweener” in size and weight. It is not a handheld or pocket, soft cover text, nor is it a comprehensive tome potentially associated with shoulder dislocations or rotator cuff tears. The book is composed of 10 sections, 7 of which are rather classic system–based presentations directed toward frequently encountered ICU problems and pathologies such as gastrointestinal hemorrhage, pancreatitis, and acute liver failure in the Gastrointestinal section. The opening section on Basic Biology of Critical Care Medicine provides a unique starting point for the textbook and consists of five superb chapters on the common mechanisms that drive life-threatening illness, including a brief overview of genetics/genomics, a burgeoning area of investigation that is likely to play an increased role in individualizing care of the acutely ill and prognosticating outcomes.
The remaining two sections focus on global therapeutic, diagnostic, and procedural interventions and the unique aspects of ICU organization, medical ethics, and end-of-life care. The discussion in the freestanding chapter on hemodynamic monitoring comments strongly on the lack of benefit derived from pulmonary artery catheterization, but interestingly, this may be the first ICU text that fails to present even a basic figure of a central venous pressure or pulmonary artery pressure tracing or, for that matter, any discussion on arterial waveforms.
The focus of the book is on adult critical care with minimal if any reference to children, with the exception of very brief comments on pediatric trauma resuscitation. The chapter on critical care management of pregnant patients is outstanding, however, and rivals those presented in any other text.
Despite the use of first-rate visual aids, there are occasions when various equations and attempts to condense complex principles into succinct tables or figures require the reader to be very attentive. For example, the chapter on acid–base presents a challenging topic and tries to incorporate elements of three schools of thought on how best to approach metabolic, respiratory, or mixed pathologies. The reader has to read the text, evaluate equations, and carefully review tables, graphs, and boxes, some of which lack clear identification of abbreviations, while trying to sort out the Stewart, Boston, or Copenhagen approach to acid–base determination.
This moderately priced overview of critical care will be well received by students, residents, fellows, and practitioners. Clinical Critical Care Medicine also includes a CD-ROM version formatted in a readily navigated style that allows access to all visual materials as downloadable slides. The book will compete favorably with, and may even supplant, some current texts in the non-tome book market. The visuals are its greatest strength and definitely meet the goal of the editors to “emphasize a visual, as opposed to a textual, presentation of material.” We added it to our libraries and encourage Journal readers do so as well.
Laura L. Hammel, M.D. Douglas B. Coursin, M.D.* *University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
American Thoracic Society Documents, Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia.. Am J Resp Crit Care Med. (2005). 171 388–416 [Article] [PubMed]