James C. Eisenach, M.D., Editor

Handbook of Critical Care, 2nd Edition. By Robert R. Kirby, Robert W. Taylor, and Joseph M. Civetta. Philadelphia, Lippincott - Raven Publishers, 1997. Pages: 940. Price:$45.00.

It seems only recently that we grumbled about the lack of quality critical care textbooks. Critical care practitioners and publishers have risen to the challenge, and there now exist books covering every aspect of critical care, from those devoted solely to organizational issues to others elucidating the molecular mechanisms of single diseases. Several comprehensive textbooks are available that encompass the broad and diverse areas of medicine that comprise critical care. Students and housestaff have also demanded books that are more portable and contain mostly practical bedside information and less pathophysiologic mechanisms. The authors of Handbook of Critical Care - Second Edition approach this need by outlining selected chapters from their reference textbook Critical Care - Third Edition. This works well for most chapters and makes the Handbook of Critical Care - Second Edition a convenient abridgement of the larger book. The outline format follows the textbook well, and many of the tables, figures, and photographs are reproduced in the Handbook. The book is of sturdy construction and excellent design. Despite its size, the text is easily readable, and the photographs exceptionally well done. The list price of 45 dollars is reasonable.

I carried the Handbook around in my pocket to test drive its usefulness during rounds in the intensive care unit and found it to be a teaching aid to the housestaff and medical students for ready demonstrations of figures and for the ability to review diseases less commonly treated in our unit. It was quickly evident that this book could serve as a general handbook for care in the hospital because of the extent to which acute medicine is covered. This clearly adds to its value beyond that of a critical care reference. Curiously discussion of postoperative management of cardiovascular and neurosurgical patients is not included. Another thoughtful feature is the extensive appendices at the back of the book that contain more than the usual amount of reference material, such as the Table fordrug dosage reductions in cases of renal failure.

The multiple author nature of the Handbook results in a variation of style among chapters, and values are not always the same. Hemoglobin's capacity for oxygen is variously stated throughout the text as 1.34, 1.36, and 1.39. Further, it often is not clear whether a statement is an opinion or supported by data.

Overall, Handbook of Critical Care - Second Edition is a useful text for the care of hospitalized patients and will be a welcome addition to many lab coat pockets.

Steven J. Allen, M.D.

Department of Anesthesiology; The University of Texas Medical School at Houston; Houston, Texas 77030