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Book Review |
University of Ottawa, Ottawa, Canada
The current edition of this textbook is advertised as the "text that has become the standard in most pediatric intensive care units." This latest edition certainly aspires to this billing as its 119 chapters in 1,871 pages combine a thorough overview of the medical specialty with a comprehensive organ systems approach to basic science, physiology and clinical medicine. Text, figures and illustrations are presented in black and white (with ten preliminary pages of 35 colour plates). Typical multi-authored chapters start with several summary statements ("pearls"), while grey shaded tables stand out from the text for ease of reference. The text acknowledges many leading centres in pediatric critical care through its inclusion of over 230 American, Canadian and international authors.
Part one of the text, titled "The Discipline," focuses on important aspects of current critical care practice beyond standard medical information. Chapters include a history of the specialty, ethical issues in invasive treatment and end-of-life care, family-centred care, transplantation and organ donation, care issues in developing countries, and the roles of nurses and sub-specialists in providing critical care. The text acknowledges the highly academic nature of pediatric critical care with chapters on evidence based medicine (with a useful table of internet resources), outcome prediction, safety and quality assessment, research (including funding and the grant application process). While the chapter on information technology includes a table of relevant pediatric critical care websites, the information on computer security and internet applications seems tangential. A better acknowledgement of present-day internet facilitated medical practice might be an on-line version of the text itself, such as the current on-line version of Miller’s Anesthesia, 6th Edition (Elsevier, Churchill, Livingstone).
The core of the text includes 81 chapters in "Organ System Function and Failure." Intensivists will note that many chapters on subjects such as asthma, ventilator- induced lung injury, transfusion medicine, and pharmacology are relevant for patients of all ages. Within these chapters, the authors are often challenged to provide a focus of materials and references that are specific to the pediatric critical care population. Chapters on more pediatric-specific topics (such as inborn errors of metabolism, cardiopulmonary bypass for repair of congenital heart disease, congenital malformations of the brain and spinal cord) are inevitably more exclusively relevant. The text finishes with five smaller sections (comprising 22 chapters) on environmental hazards, trauma, basic pharmacology, anesthesia and analgesia, and cardiopulmonary resuscitation.
Overall, this reference textbook provides a solid and complete overview of pediatric intensive care practice. While non-pediatric intensivists and pediatric anesthesiologists may appreciate many chapters that are up to date in their areas of expertise, they are likely to find very similar reference chapters in other sources more specific to their respective medical specialties. Nonetheless, this current edition of Pediatric Critical Care will certainly become a standard ‘one-stop’ reference text for consultants, fellows, and residents in pediatric critical care.
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