Cardiopulmonary critical care

Cardiopulmonary Critical Care is a conveniently small textbook that discusses clinically relevant physiology and treatment of cardiac and pulmonary derangements in intensve care unit patients. I appreciate the compact size of this textbook because my stamina for lifting heavy, more comprehensive textbooks is yielding to the electronic medium. By restricting discussions to cardiac and pulmonary areas, I found that this compact textbook comprehensively covered topics such as advanced ventilator modes and techniques, the variety of new drugs available to treat cardiac and hypertensive disorders, and the unique problems encountered in cardiac and thoracic surgical and trauma patients. As pointed out by its editors, the book is designed for '… clinicians with intermittent responsibilities for critically ill patients in a world of competing demands.' With this goal in mind, I wonder whether this type of clinician will spend much time with the discussions of respiratory and cardiac physiology that are found at the beginning of the textbook. Some of these discussions are quite basic and are readily found in surgical, internal medicine, and anesthesiology textbooks, as well as in most critical care textbooks. Examples include discussions of acid–base abnormalities, oxygen transport, and lung mechanics. I am convinced, however, that intermittent critical care physicians will find the discussions of newer and increasingly popular medications and treatment approaches very practical. When, for example, should vasopressin be used for hypotension? When should a patient with acute lung injury be placed in the prone position? Should lipid-lowering therapy be used in the immediate period after a patient presents with an acute coronary syndrome? The discussions of these topics are well referenced. The authors clearly state when there is controversy and when supporting literature is lacking. Critical care medicine has seen an explosion in new ventilator technologies. With the exception of pulmonary and critical care specialists, it is not unusual for physicians to be overwhelmed with advanced ventilator terminology and techniques. I found that the chapters on mechanical ventilation, including modes of ventilation, weaning from mechanical ventilation, and the use of noninvasive ventilation, were lucidly written and well referenced. The serious reader of these chapters will find the basics of volume and pressure targeted modes (traditional and untraditional), auto-PEEP (auto positive end-expiratory pressure), and weaning techniques clearly presented with clarifying illustrations. Discussions of advanced ventilator management including lung protective strategies, airway pressure release ventilation, and pressure control inverse ratio ventilation will be useful to the advanced …