Book Review

Critical care medicine in India is a nascent superspeciality with rapidly expanding horizons. As expected, there are not enough training courses. Intensivists are expected to be thoroughly conversant in the aetiology, physiopathogenesis of illnesses affecting several organ systems and their management, and not limited to a single organ system or a speciality. They need to be knowledgeable about treatment options and be able to weigh the pros and cons in any given case. Any education that is imparted to the beginners in this branch and also to the non-specialists, thus assumes greater importance. Hence, their training needs to be evidence-based to meet the currently prevailing standards in medicine. This book provides succinct information to the trainees, and physicians who deal with critically ill individuals, as the first hospital contact.

The editors of the book have made a laudable effort to describe the common problems seen in the critically ill. The book has 50 chapters, dealing with topics which are a mix of common reasons of case presentation and their treatment in a stepwise manner and bedside imaging using ultrasonography, invasive and non-invasive monitoring and a few chapters on mechanical ventilation. There are chapters which may appear to be too advanced for the novices, such as extracorporeal membrane oxygenation, but this may serve as an introduction to the cutting-edge technology to the readers. The book provides algorithms wherever possible and clinical photographs which add value to the supporting content.

The book would have been more beneficial to the readers and would have made a more coherent reading, if the topics were better organized in sections such as general care of the critically ill; administrative, ethical and medico legal considerations; common clinical problems and chapters on commonly used organ support therapies.

When writing a handbook, the authors are often restrained by the length, and it is difficult to achieve a balance between the two categories namely, ‘must be known’ and ‘not that essential’. The other minor issue is that all authors are from the same institute, which can be good for the editor, in that one can control the substance of the topics written and most importantly the timelines of submission. However, having all the authors from one’s own institute, may run the risk of undermining the possible expertise available with other leading teachers from the country who are masters of various areas.

The overall table of content appears to cover all topics at the first glance; however, in the conscious desire to be brief and precise in keeping with the nature of the book, some important areas seem to have been missed. One such example is the missing discussion about hypocalcaemia and hypercalcaemia, in the chapters on common electrolyte disorders. Both are common, and hypercalcaemia often signifies poor prognosis, particularly in cancer patients. Overall, this is a handy book for the beginners and those who only occasionally have to deal with the critically ill and quite useful at the bedside.