Br. J. Anaesth. (1983), 55,259
BOOK REVIEWS Edema of the Lung. By J. S. Prichard. Published (1982) by Charles C. Thomas, Springfield, 111. Pp. 456; indexed. Price $45.75.
The Quality of Cart in Anaeithesia. Edited by Betty L. Grundy and J. S. Gravenstein. Published (1982) by C. C. Thomas, Springfield, Illinois. Pp. 255; indexed.
In the wake of the Association of Anaesthetists' recent report on Mortality Associated with Anaesthesia, a general consideration of the quality of care in anaesthesia and the factors affecting it is particularly fitting. Although this book, edited by Professors Grundy and Gravenstein, follows on a Workshop on the subject held in Pittsburgh as long ago as June 1980, much that is discussed is highly relevant to British practice now. To quote: "Though serious complications of anaesthesia are relatively rare, the total morbidity and mortality related to anaesthesia in this country are large enough to deserve serious consideration". The debate, currently pretty lively, must not be allowed to fade into Rtspiratory Monitoring in Intensive Can. Edited by A. A. Spence. the background and our knowledge of the current state of practice Published (1982) by Churchill Livingstone, Edinburgh and must be made more precise in order that areas of weakness can be London. Pp. 162; indexed; illustrated. Price £14.50. highlighted and appropriate action taken to improve the outcome This book reviews the present state in the monitoring of many for our patients. aspects of respiratory function. The individual authors are ackThe articles in this book are conveniently arranged and, under nowledged experts in their selected fields. The subjects covered the headings of structure, process, outcome WT*d policy planning, include the measurement of gas flow and the interpretation of many pertinent topics are considered: manpower, human error, pressure-volume loops during spontaneous and controlled venti- the effect of new technology and so on. The importance of each lation. In vivo, in vitro and laboratory blood-gas analyses are department acquiring reliable data as a starting point in improvdiscussed, as are the potential benefits of capnography in the ing quality is quite rightly given considerable pFPTi'i"^?!^*^. The Operating Room and Intensive Therapy Unit. There is a particu- inadequacy of most record-keeping is emphasized, documentalarly interesting chapter which describes the use of the respiratory tion being "invariably incomplete, sometimes inaccurate and mass spectrometer. frequently unreliable" and the question a^Vrd whether we cannot Most of the contributions are short; for example Severinghaus "adopt and use the methods that technology extends to us to describes the problems which beset the use of transcutancous replace the hand-written, carbon-smudged, inconsistently faithful anaesthesia record." carbon dioxide tension monitoring in only seven pages. ElseThose anaesthetists who are alive to the importance of this where it is emphasized that the transcutaneous oxygen electrode is reliable only in neonatal practice. The authors of the section on subject will not find any particularly novel material in this in vivo fibreoptic analytical systems are able to complete their publication, but it is well set out and lucidly discussed by expeils. Furthermore, the emphasis on the development of dearer and review in eight pages. On the other hand, the chapter on laboratory blood-gas analysis is the longest in the book and is a particu- more coherent policies in anaesthetic practice to fninimiT^ patient larly clear exposition of the various methods available. It is risk is helpful. pleasing to learn that the instrument manufacturers are closely When allowance is marf^ for the difference between U.S.A. approaching the ideal system, for the nnn-tj*rlininynj of a. device practice and that in thin country, it is surprising how much of thin which has only one control knob. exchange of ideas in published form is highly relevant. It can be Much of the material pam nted describes well established recommended for H^jmrtin^ntal libraries as a useful addition to techniques and the dates of the relevant references suggests that the growing literature on this important topic. D. Campbell little new work is emerging. In those sections where more novel
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One of the hazards of writing on a rapidly developing subject is that the delay between Writing and publication can make the work out-of-date before publication. Dr Prichard recognizes this problem with his book and in an addendum cites some more recent review articles. The book is divided into two sections, thefirston the physiology of lung water and second on the physiology of experimental and clinical pulmonary oedema. The first section is an excellent exposition of the distribution of water between the different compartments of the lung and the interrelationship between them. There is some duplication between the different chapters, but this adds to the ease of understanding rather than intruding. The lack of up-to-date work is most evident in the second section on experimental and clinical pulmonary oedema. However, the work reviewed is presented in a clear fashion and is well referenced. The book is well produced, with very few misprints. Comprehensive name and subject indexes are provided. This volume is recommended for those wishing a comprehensive introduction to pulmonary oedema, but those seeking a review of more recent developments are advised to look elsewhere. C. D. Homing
methods are described many of the references are recent. The book is well produced and the illustrations and diagrams clear and helpful to the reader. The index is short, but perfectly adequate for a book of this nature. It is not customary to mention misprints in a review, but among the small number noted was the absence of one author's name from the lilt of contributors. In summary, this is a very good and up-to-date book which will find a useful place in the Library of the Anaesthetic Department and the Pulmonary Function Laboratory. / . C. Stoddan