Classic Papers in Critical Care.

British Journal of Anaesthesia 92 (3): 456±8 (2004)

Book Reviews Classic Papers in Critical Care. M. Fink, M. Hayes and N. Soni (editors). Published by Bladon Medical Publishing, Oxford. Pp. 580; indexed; illustrated. Price £49.95. ISBN 1-904218-21-0. As stated in the preface, critical care medicine has come of age. It is no longer the poor relation of other specialties and the research and development in recent years re¯ects this. In fact, many of the important advances in critical care management have the unique status of having occurred within the living memories of the authors. It is this burgeoning of ideas and output that this book is attempting to rationalize. Does it succeed? On the whole, I think the answer is `yes'. The editors have been careful to select a truly expert and international group of contributors, each a recognized expert in critical care or an allied specialty. This gives strength and credence to a text that is attempting to do the impossible. Many of the authors are at pains to stress that the choices of `classical' papers are their own and although many readers will ®nd worthy papers omitted, the choices do largely make sense. The book is composed of 21 chapters. There has been an attempt to be comprehensive but there are signi®cant gaps. I wonder whether the titles of the chapters are as much a re¯ection of the expertise of the contributors as the editors' choices. The chapters begin with an introduction from the contributor, which is then followed by reports of 10 papers. Each report consists of the reference, its abstract, a summary by the contributor, a citation count, key related references, the key message, why the paper is important, its strengths, its weaknesses, and ®nally its relevance to critical care medicine. Figures and illustrations are sometimes included. This format is very clear and works well. The chapters are as follows: ventilation, acute lung injury, the heart, severe traumatic brain injury, the gut and its role in circulatory shock, renal support, the liver in critical illness, burns, trauma, clinical sepsis, nutrition and metabolism, ¯uids, infection in intensive care, infectious diseases, vasoactive and cardiotonic drugs, pain relief and sedation on intensive care, monitoring, scoring systems, ethics, cytokines, and paediatric critical care. The way contributors have interpreted their remit varies quite considerably. Some chapters are a broad overview of a subject, such as the renal support chapter but others are much more focused such as the chapter on severe traumatic brain injury. This means that some issues are dealt with comprehensively whilst others are missed. For example, there are no other chapters on neurological problems apart from trauma. The contributors also vary in what they de®ne as a classic paper. Some have looked back and give a very historical perspective, taking the reader from the origins through development to current opinion (e.g. the heart). Alternatively, other contributors have chosen only recent and current papers resulting in a sort of current controversies chapter (e.g. infection in the intensive care unit). The introductions similarly vary. The best example is probably the chapter entitled `Clinical sepsis'. The contributor has used the introduction to outline the historical development and de®nition of sepsis, ending with some of the current developments. Then there are the 10 papers and ®nally the contributor has written a summary to challenge the current state of research, with a list of 65 further references. Surprisingly, only one paper was chosen by more than one contributor and that was the restriction of ¯uid to trauma victims by Bickell and colleagues. This was chosen in chapter 9 (Trauma) and chapter 12 (Fluids). One observation to be made from the choice of papers is how few large randomized controlled trials

there are in critical care medicine. This of course re¯ects the dif®culties of research in this area and is one reason why a book such as this is very useful. This book is not designed to facilitate a student with facts. Its purpose is to encourage thought and to `serve as a catalyst for discussions'. Personally, I think it would be invaluable to all trainees in critical care. It gives perspective to the subjects, as well as giving the trainee a starting point from which to explore further research. The list of contributors is impressive. It is a book that should have further editions, with either different chapters or as new `classic papers' appear, updated chapters. This is a book I could recommend to any ITU department and to any individual embarking on a career in critical care research. B. Philips London, UK

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DOI: 10.1093/bja/521