Principles and Practice of Intensive Care Monitoring. Edited by Martin J. Tobin. New York, McGraw-Hill, 1998. Pages: 1200. Cost:$140.00.
The past decade has seen multiple textbooks on monitoring, usually smallish mes that provide detailed information on common monitoring procedures and their underlying technology. The new textbook, Principles and Practice of Intensive Care Monitoring, takes a much broader view of monitoring, including all forms of monitoring used in the intensive care unit and focusing on how physiologic data can be used to modify patient outcomes. The book contains detailed reviews of most of the available methods for obtaining physiologic data from patients in the intensive care unit. Many of these methods are in common use, whereas others are state-of-the-art procedures used in only a few specialized centers. Much attention is devoted to analyses examining the accuracy (and usefulness) of the data generated by these devices and to how physicians and other care givers can use this information to manage complex patients in the intensive care unit. Chapters are grouped together by organ system, with respiratory and cardiovascular monitors receiving the most attention. There are also chapters dealing with specific situations (e.g. , transport) and technologies (e.g. , molecular biologic tests). Topics range from the very technical (engineering data on alarms—their frequency, pitch, and intensity) to the purely clinical (indications for placing a pulmonary artery catheter). Taken as a whole, Tobin has created a unique book—one that redefines what monitoring is all about.
The book is large and expansive and is aimed at the intensivist who wishes to use technology wisely and provide high-quality patient care. Although certain chapters can serve as reference standards (e.g. , techniques to measure respiratory muscle strength), the book can also function as a series of interesting and useful reviews to be read at one's leisure. The chapters addressing the potential utility of computers in medicine are particularly interesting, providing insight both into the potential offered by this technology and the daunting hurdles that must be circumvented to translate this potential into useful clinical tools.
The authors are leaders in their fields. The overall quality of writing is high. All forms of monitoring modalities are covered. Although one can quibble that some topics are covered in excessive depth (in comparison to the whole) and a few chapters fail to deliver a clear message, the balance is excellent, and there is minimal overlap between chapters.
In summary, this is an excellent textbook and well worth the price. Intensivists will find it both stimulating and useful. It belongs in the library of all major hospitals and medical schools.
