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Current critical care: up-to-date diagnosis and treatment

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In general, textbooks in medicine that try to cover all areas of a specialty are either huge volume editions, which therefore serve as a reference whenever there is enough time for a thorough search, or they present as pocket books that help to quickly decide when peer assistance is not readily available. Although Current Critical Care Diagnosis & Treatment with its 945 pages certainly is somewhat inconvenient for becoming a 'pocket book' in the narrower sense of the word, its organization invites students, house officers, fellows or those preparing examinations to have it on their bookshelf and to look at it both when time is available as well as when rapid decision-making is mandatory.

Admittedly, the book does not cover pediatric critical care nor does it provide bedside technical procedure, nursing and administrative chapters. Nevertheless, a number of crucial chapters that are often neglected or at least under-represented largely outweigh this inconvenience; for example, those chapters on the philosophy of critical care, pharmacokinetics, anesthesia and analgesia, patient transport, ethical considerations, psychiatric problems and the care of the elderly. In other words, a significant proportion is dedicated to subjects for which research data are often scarce but which make up for steadily growing problems in the management of the critically ill.

The presentation of the book has three major highlighting factors. First, after dealing with fundamentals of critical care medicine as a whole, the book addresses both surgical and medical – where possible directly succeeding each other, such as the chapters on neurologic diseases and neurosurgical critical care – and thereafter discusses pathophysiologic aspects on organ-specific or disease-specific approaches. Furthermore, Current Critical Care Diagnosis & Treatment comprises numerous convincing and instructive tables both on clinical and laboratory findings as well as on therapeutic and dosing guidelines – an ideal source both for those looking for quick information and for those searching for background knowledge. Finally, I particularly like the 'Essentials of diagnosis' that introduce the individual chapters, important guidelines for the clinician training in intensive care medicine.

Are there any items or ideas that I missed? Unfortunately, yes. I only found carbon monoxide intoxications in the Burns chapter (by the way, nowhere in the index!), and neither are high-altitude disorders or diving emergencies dealt with in the Environmental Injuries chapter nor do the mentioned iatrogenic problems refer to gas embolism. Being a 'European intensivist', I also missed the issues 'inhaled prostacyclin' and 'transpulmonary thermodilution' as well as 'pulse contour analysis' in the respective chapters on Cardiothoracic Surgery, Respiratory Failure and Intensive Care Monitoring.

As a whole, Current Critical Care Diagnosis & Treatment is thus not only one additional single source reference textbook of critical care, but it is worthwhile reading thanks to the good chapters already highlighted. Hopefully, the lacking issues will be covered in a subsequent edition.

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Correspondence to Peter Radermacher.

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Radermacher, P. Current critical care: up-to-date diagnosis and treatment. Crit Care 8, 142 (2003).

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  • medical intensive care
  • surgical intensive care
  • textbook