Synopsis of Intensive Care Medicine. L. I. G. WORTHLEY. Churchill Livingstone, 1994. Price £59.50. pp. 985.
The basis of this textbook is that the understanding of human physiological principles is fundamental to critical illness diagnosis and management. The book therefore attempts to be both a physiology text and a synopsis of medicine relevant to the field of intensive care. The bulk of the text, which is devoted to adult medicine, is single author. A smaller section on paediatric intensive care is provided towards the end of the text by a separate contributor.
The book is divided in a traditional manner into 12 sections on cardiovascular disorders, respiratory disorders, renal disorders and neurological disorders etc. It is well-written and clear, benefiting from the continuity provided by a single author. It is clearly something of a labour of love for an experienced lecturer and researcher in intensive care, and this feeling extends throughout the text. The emphasis is on the medical as opposed to the surgical aspects of intensive care, although useful chapters on trauma are included in the respiratory, gastrointestinal and neurological sections. The book contains a wealth of useful information mostly relevant to intensive care, although there is a significant general medical content. A number of important intensive care topics do not easily fit into strict organ-system divisions, this results in some topics becoming fragmented, e.g. obstetric disorders, or located in less than obvious sites e.g. multiple organ failure in gastrointestinal disorders, or not included e.g. near-drowning, and transportation of the critically ill. Some conditions and therapies have more emphasis than others, presumably reflecting particular interests of the author. For instance in the 'inotropes' chapter noradrenaline, a drug currently used widely and frequently in the management of shocked states, merits half a page; whereas digoxin, an infrequently used inotrope in intensive care, is given five pages.
These criticisms are, however, minor and peripheral and do not detract from the value of this book as both a guide to the physiological basis of intensive care and a bridge between pocket handbooks of intensive care and large comprehensive textbooks on the subject.
For any junior doctor wishing to embark on a career in intensive care this text would provide a solid foundation of knowledge.
R. M. SLATER