Principles and Practice of Intensive Care Monitoring

Principles and Practice of Intensive Care Monitoring, M. J. Tobin, ed. New York: McGraw Hill, 1998. ISBN 0-07-065094-2, 1525 pp., $145.00. Even the library of the intensive care unit (ICU) regularly gets new equipment of different fields, value, and weight. The latest oeuvre of Martin Tobin is one of the bigger pieces added to the bookshelf, but it also represents one of its best values. Principles and Practice of Intensive Care Monitoring is a remarkable book. The 130 contributors include a number of renowned American, Canadian, and European clinicians and investigators. The book reflects a wide variety of domains and approaches in the field of monitoring the critically ill patient. As expected, a prominent space is occupied by surveillance methods and techniques for respiratory and cardiocirculatory function. In addition, other vital organ systems-i.e., central nervous system, kidney, and liver-get appropriate attention. This book is not consecrated to a description of technology. The presentation of monitoring is much larger. Important parts are devoted to clinical monitoring, and this reviewer certainly does not believe that the equipment is getting excessive attention, or that the patient is lost in a jungle of wires and computers. Examples of the breadth of topics are reflected in chapter titles such as "Ethical Issues in the Institution and Discontinuation of Monitoring." Thoughtful advice is given concerning unproven techniques and devices that are widely used today, including intracranial pressure, gastric mucosal pH and PCO2 monitoring, and (ab)use of the pulmonary artery catheter. Other chapters titles include "Alarms," "Decision making," and "Oxygen Transport and Consumption." There are seven chapters related to the use of the pulmonary artery catheter, its indications, and complications: "Peripheral Neuromuscular Function," "Point-of-Care Testing," "Respiratory Pressure-Volume Curves," "Therapeutic Drug Monitoring," and "Tools of Molecular Biology." This last chapter is a real achievement in its very clear presentation of the modern salt and pepper in biochemical ICU monitoring. Much energy has been invested in the production of this easy-to-read text, interspersed with high-quality photographs and figures. The reader will learn much not only about monitoring, but also about many other aspects of intensive care medicine, including therapeutic strategies and their evaluation. The editor is to be congratulated for producing such a fine book. Anesthesiologists involved in the care of the critically ill will find not only a patient-centered approach for the ICU, but also some elements to make them feel more knowledgeable and confident about reliable monitoring techniques for the time not spent directly with the patient. Peter M Suter, MD, FRCA Surgical Intensive Care Unit; Hopital Cantonal Universitaire; CH-1211 Geneve, Switzerland