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Principles of critical care
JOURNAL OF VASCULAR SURGERY Volume 18, Number 1
lent examples of how each type of study contributes to establishing the diagnosis. Unfortunately, these chapters lack important references on the specificity and sensitivity of CT scans, M R I scans, and myelography. Most sections of this book include quality descriptions of surgical indications, techniques, and results written by respected orthopedic and neurosurgical spine specialists. As has been true since the original description by Dr. Verbiest, the precise indications for surgery are still unclear. It is similarly unclear whether decompression surgery should include a concomitant fusion procedure. The controversy surrounding the use of spinal insmLmentation is addressed and the basics of these techniques are reviewed. The indications for surgical treatment and the type of surgical treatment clearly remain quite controversial, as exemplified by the variability of the results reported in the literature. The degree of controversy is reasonably well addressed by the contributors. Lumbar Spinal Stenosis is a valuable text with sufficient history, anatomy, diagnostics, and illustrations of surgical technique to make it a worthwhile addition to the library of orthopedic, neurosurgery, and neurology residencies. It will serve as a valuable resource for vascular surgeons desiring detailed information on this important type of neurogenic clandication. Timothy L. Keenen, M D Oregon Health Sciences University Portland, Ore.
Interventional radiology Renan Uflacker, Mark H. Wholey, New York, 1991, McGraw-Hill Publishing Company, 619 pages, $149. This comprehensive work on interventional radiology is dominated by a discussion of percutaneous embolization procedures (nearly one half of the text). The balance of the text is divided among biliary interventions, percutaneous urinary tract interventions, the percutaneous drainage of abdominal collections, and percutaneous vascular interventions. The organization is not logical. Nonvascular interventions are interspersed between vascular procedures. Angioplasty and related vascular procedures are not adequately covered. The angioplasty section and the sections on mechanical recanalization techniques and thrombolysis are hampered by the presence of flawed data, broad generalizations, and some significantly out-of-date informarion. The text is worthwhile for both interventional radiologists and nonradiologists, because it discusses embolization procedures. Although the authors' choice of embolic agents for specific entities is often arguable, it is a comprehensive review and includes (perhaps inappropriately) a chapter with a discussion of percutaneous management of intracranial disorders. The authors give the reader some insight into the tone of the text with their first chapter, a discussion of catheterization techniques. Detailed discussions of arterial puncture, guide wire introduction, catheterization, and
Book reviews 143
catheter manipulation, including methods for reforming Simmons' catheters, are included. This fundamental material is beneath the scope ofinterventional radiology training or practice. These basics and some broad generalizations diminish the value of the text for the interventional radiologist in training or in practice. Furthermore, the relative lack of detailed discussion of the complications associated with percutaneous vascular procedures compromises the text for interventional radiologists and vascular surgeons. Donald E. Schwarten, M D Indianapolis, Ind.
Principles o f critical care Jesse B. Hall, New York, 1992, McGraw-Hill, 2432 pages, $155. In their introduction the editors note that, "Critical care has evolved over the last four decades into a subspecialty of anesthesia, medicine and surgery." They argue that as a result of the complexities of critical care the specialist must be thoroughly acquainted with all three fields. This 12-pound, 2432-page book leaves few subjects in any of these three subspecialties untouched. The book is organized into 4 parts, 20 sections, and 189 chapters. Part one discusses the pathophysiology of critical illness. The chapters on respiratory and cardiovascular physiology, although complete and accurate, are long, tedious, and filled with equations. Although these chapters could be useful for a physiology class, they will be of little help to the student or resident rotating through the intensive care unit (ICU) in search of a concise and practical review. The chapter on acid-base and electrolyte homeostasis is easier to read and more practical. The chapters on neurophysiology and gastrointestinal physiology are redundant, and much of the information is repeated elsewhere in the text. Several chapters in part 2 are devoted to the overall management of the ICU. Issues ranging from the economics of running an ICU to quality assurance are addressed. Also included are descriptions of a multitude of procedures that might be performed in an ICU. Many of the procedural descriptions are practical and informative; the chapter on vascular cannulation is excellent. A notable exception is a chapter entitled "Evaluation of the Patient With Peripheral Vascular Disease," which is almost completely devoted to noninvasive vascular testing and does not address the clinical principals of the vascular examination. Part 3 is devoted to discussions of individual disease states. This portion of the book is overwhelming, containing 133 chapters and covering a bewilderingly wide group of topics, ranging from animal poisoning, seizures, and Rocky Mountain spotted fever to cardiac surgery. It is as if Schwartz's Principles of Surgery and Harrison's Textbook of Medicine had been combined into one large compendium. Despite the enormity of this section, many of the chapters are excellent and well written by knowledgeable authors. Residents or staffunfamiliar with a particular disease state
JOURNALOF VASCULARSUV,GERY
144 Book reviews
could consult this text for a practical review of almost any subject, and in most cases critical care issues are appropriately emphasized. Part 4 is rifled "Perspectives on Critical Care." A chapter that discusses critical care issues for nursing staff is interesting and informative. A long chapter on international perspectives on critical care has limited Value. Overall, this text is well organized, well written, and certainly complete. Unfortunately, the book's length limits its utility. It would not be a useful addition to a vascular surgeon's library. It may serve as an excellent reference book for critical care specialists and may be a useful text to have on hand in an ICU.
Craig Kent, MD Beth Israel Hospital Boston, Mass.
Current surgical therapy, 4th edition John C. Cameron, Philadelphia, 1992, B.C. Decker, 1102 pages, $99. The fourth edition of Current Surgical Therapy has expanded in size to 1000 pages and includes, for the first time, a section on surgical critical care. It is noteworthy that every chapter is authored by a clinical surgeon with a reputation for excellence. These contributors add immeasurably to the success of the book by presenting both up-to-date surgical methods and excellent personal clinical results that will serve as a goal for the rest of us to attain. The new section on surgical critical care presents a good review of the care of the critically ill patient, including not only basic parameters, such as care of patients with respiratory failure, but also an extensive section on cardiovascular drug therapy. Other areas of critical care are well covered, and this new section generally presents a comprehensive review of the care of the severely ill patient undergoing surgery. The section on general vascular and peripheral vascular problems is generally well done, although, not surprisingly, somewhat limited in scope from the vantage of a fully trained vascular surgeon. The section on carotid artery disease and other vascular disease such as coronary artery disease is particularly well done. The section on peripheral artery embolus is obviously for the general surgeon occasionally involved in reconstruction of embolically occluded vessels. O f note is that there is no mention of adjuncts in distal embolectomy, such as the use of angioscopy, which is clearly more accurate in detecting residual thrombus than arteriography. The author discusses fasciotomy but omits any mention of methods for measuring compartment pressures and/or clear indications for fasciotomy. This book ~11 be useful to the vascular surgeon in that it extensively reviews problems in surgery that may involve the vascular surgeon and the patient undergoing vas~lar surgery, including special instances of trauma, gastrointestinal reconstruction, and critical care. The close interaction of the vascular surgeon with the general surgeon requires
July 1993
a knowledge by both of current practices and methods of therapy presented herein. This book is an important resource to the vascular surgeon and will be a most helpfial reference.
WilliamJ. Fry, A4D St. JosephMercy Hospital Ann Arbor, 2~lich. /
Principles o f trauma surgery Joseph A. Moylan, New York, 1992, Raven Press, 448 pages, $155. To discern how well Moylan's Principles of Trauma Surgery provides a comprehensive review of the principles and practice of trauma care, I have compared it with the recently issued Trauma by Moore, Mattox, and Feliciano (reviewed here in January 1992 by Richard J. Mullins, MD). Each work costs about $150, but the book by Moore et al. is substantially more comprehensive: Principles of Trauma Surgery has 448 pages and uses a relatively capacious 10-point typeface, whereas Trauma has slightly more than 1000 pages in a smaller 8-point typeface. Moylan covers this whole topic o f trauma care in only 22 chapters, each averaging about 20 pages. Moore et al. uses 63 chapters to discuss a whole series of issues-trauma center designation, epidemiology, organ procurement, alcohol and drugs, radiation injury, geriatric trauma, and disaster planning- touched on only in passing or not at all in Moylan's book. I note with concern that Moylan, an expert in burn care, has dealt with the management of thermal injury in Chapter 17, but in so doing significantly duplicates the commentary of Pruitt and Goodwin in their chapter on wound care. Similar repetition is evident; for example many of Meyer's comments on critical care repeat those made in other chapters. Up-to-date references are critical for a text. The turnaround time for a new textbook is about 18 months, and none can be expected to have references more recent than 2 years before publication. On the other hand, in a field as rapidly changing as trauma care, at least some of the references ought to be contemporary. Unfortunately, only one c h a p t e r - o n splenic trauma by McCarthy and G l o v e r - really meets this requisite in Principles of Trauma Surgery. In fact, with only a few exceptions among the text's hundreds of references, the most recent citations are from 1985 or, rarely, 1986. Most of these chapters were written by the same authors as in Moylan's first edition in 1988 and contain few if any updated references. McCann and Makhoul present a workmanlike 20-page review of vascular trauma (Moore et al. allot three chapters and 60 pages), but except for a pair of their own case reports in the JOURNAL OF VASCULAR SURGERY,they provide few references more recent than 1 9 8 3 - a n d none since 1986. They dismiss compartmental hypertension and recent investigations into its pathophysiology in less than a paragraph. The reader will look in vain for answers to questions such as the following: "Can I use a synthetic graft in case of penetrating vascular trauma?" "Is there a role for
lent examples of how each type of study contributes to establishing the diagnosis. Unfortunately, these chapters lack important references on the specificity and sensitivity of CT scans, M R I scans, and myelography. Most sections of this book include quality descriptions of surgical indications, techniques, and results written by respected orthopedic and neurosurgical spine specialists. As has been true since the original description by Dr. Verbiest, the precise indications for surgery are still unclear. It is similarly unclear whether decompression surgery should include a concomitant fusion procedure. The controversy surrounding the use of spinal insmLmentation is addressed and the basics of these techniques are reviewed. The indications for surgical treatment and the type of surgical treatment clearly remain quite controversial, as exemplified by the variability of the results reported in the literature. The degree of controversy is reasonably well addressed by the contributors. Lumbar Spinal Stenosis is a valuable text with sufficient history, anatomy, diagnostics, and illustrations of surgical technique to make it a worthwhile addition to the library of orthopedic, neurosurgery, and neurology residencies. It will serve as a valuable resource for vascular surgeons desiring detailed information on this important type of neurogenic clandication. Timothy L. Keenen, M D Oregon Health Sciences University Portland, Ore.
Interventional radiology Renan Uflacker, Mark H. Wholey, New York, 1991, McGraw-Hill Publishing Company, 619 pages, $149. This comprehensive work on interventional radiology is dominated by a discussion of percutaneous embolization procedures (nearly one half of the text). The balance of the text is divided among biliary interventions, percutaneous urinary tract interventions, the percutaneous drainage of abdominal collections, and percutaneous vascular interventions. The organization is not logical. Nonvascular interventions are interspersed between vascular procedures. Angioplasty and related vascular procedures are not adequately covered. The angioplasty section and the sections on mechanical recanalization techniques and thrombolysis are hampered by the presence of flawed data, broad generalizations, and some significantly out-of-date informarion. The text is worthwhile for both interventional radiologists and nonradiologists, because it discusses embolization procedures. Although the authors' choice of embolic agents for specific entities is often arguable, it is a comprehensive review and includes (perhaps inappropriately) a chapter with a discussion of percutaneous management of intracranial disorders. The authors give the reader some insight into the tone of the text with their first chapter, a discussion of catheterization techniques. Detailed discussions of arterial puncture, guide wire introduction, catheterization, and
Book reviews 143
catheter manipulation, including methods for reforming Simmons' catheters, are included. This fundamental material is beneath the scope ofinterventional radiology training or practice. These basics and some broad generalizations diminish the value of the text for the interventional radiologist in training or in practice. Furthermore, the relative lack of detailed discussion of the complications associated with percutaneous vascular procedures compromises the text for interventional radiologists and vascular surgeons. Donald E. Schwarten, M D Indianapolis, Ind.
Principles o f critical care Jesse B. Hall, New York, 1992, McGraw-Hill, 2432 pages, $155. In their introduction the editors note that, "Critical care has evolved over the last four decades into a subspecialty of anesthesia, medicine and surgery." They argue that as a result of the complexities of critical care the specialist must be thoroughly acquainted with all three fields. This 12-pound, 2432-page book leaves few subjects in any of these three subspecialties untouched. The book is organized into 4 parts, 20 sections, and 189 chapters. Part one discusses the pathophysiology of critical illness. The chapters on respiratory and cardiovascular physiology, although complete and accurate, are long, tedious, and filled with equations. Although these chapters could be useful for a physiology class, they will be of little help to the student or resident rotating through the intensive care unit (ICU) in search of a concise and practical review. The chapter on acid-base and electrolyte homeostasis is easier to read and more practical. The chapters on neurophysiology and gastrointestinal physiology are redundant, and much of the information is repeated elsewhere in the text. Several chapters in part 2 are devoted to the overall management of the ICU. Issues ranging from the economics of running an ICU to quality assurance are addressed. Also included are descriptions of a multitude of procedures that might be performed in an ICU. Many of the procedural descriptions are practical and informative; the chapter on vascular cannulation is excellent. A notable exception is a chapter entitled "Evaluation of the Patient With Peripheral Vascular Disease," which is almost completely devoted to noninvasive vascular testing and does not address the clinical principals of the vascular examination. Part 3 is devoted to discussions of individual disease states. This portion of the book is overwhelming, containing 133 chapters and covering a bewilderingly wide group of topics, ranging from animal poisoning, seizures, and Rocky Mountain spotted fever to cardiac surgery. It is as if Schwartz's Principles of Surgery and Harrison's Textbook of Medicine had been combined into one large compendium. Despite the enormity of this section, many of the chapters are excellent and well written by knowledgeable authors. Residents or staffunfamiliar with a particular disease state
JOURNALOF VASCULARSUV,GERY
144 Book reviews
could consult this text for a practical review of almost any subject, and in most cases critical care issues are appropriately emphasized. Part 4 is rifled "Perspectives on Critical Care." A chapter that discusses critical care issues for nursing staff is interesting and informative. A long chapter on international perspectives on critical care has limited Value. Overall, this text is well organized, well written, and certainly complete. Unfortunately, the book's length limits its utility. It would not be a useful addition to a vascular surgeon's library. It may serve as an excellent reference book for critical care specialists and may be a useful text to have on hand in an ICU.
Craig Kent, MD Beth Israel Hospital Boston, Mass.
Current surgical therapy, 4th edition John C. Cameron, Philadelphia, 1992, B.C. Decker, 1102 pages, $99. The fourth edition of Current Surgical Therapy has expanded in size to 1000 pages and includes, for the first time, a section on surgical critical care. It is noteworthy that every chapter is authored by a clinical surgeon with a reputation for excellence. These contributors add immeasurably to the success of the book by presenting both up-to-date surgical methods and excellent personal clinical results that will serve as a goal for the rest of us to attain. The new section on surgical critical care presents a good review of the care of the critically ill patient, including not only basic parameters, such as care of patients with respiratory failure, but also an extensive section on cardiovascular drug therapy. Other areas of critical care are well covered, and this new section generally presents a comprehensive review of the care of the severely ill patient undergoing surgery. The section on general vascular and peripheral vascular problems is generally well done, although, not surprisingly, somewhat limited in scope from the vantage of a fully trained vascular surgeon. The section on carotid artery disease and other vascular disease such as coronary artery disease is particularly well done. The section on peripheral artery embolus is obviously for the general surgeon occasionally involved in reconstruction of embolically occluded vessels. O f note is that there is no mention of adjuncts in distal embolectomy, such as the use of angioscopy, which is clearly more accurate in detecting residual thrombus than arteriography. The author discusses fasciotomy but omits any mention of methods for measuring compartment pressures and/or clear indications for fasciotomy. This book ~11 be useful to the vascular surgeon in that it extensively reviews problems in surgery that may involve the vascular surgeon and the patient undergoing vas~lar surgery, including special instances of trauma, gastrointestinal reconstruction, and critical care. The close interaction of the vascular surgeon with the general surgeon requires
July 1993
a knowledge by both of current practices and methods of therapy presented herein. This book is an important resource to the vascular surgeon and will be a most helpfial reference.
WilliamJ. Fry, A4D St. JosephMercy Hospital Ann Arbor, 2~lich. /
Principles o f trauma surgery Joseph A. Moylan, New York, 1992, Raven Press, 448 pages, $155. To discern how well Moylan's Principles of Trauma Surgery provides a comprehensive review of the principles and practice of trauma care, I have compared it with the recently issued Trauma by Moore, Mattox, and Feliciano (reviewed here in January 1992 by Richard J. Mullins, MD). Each work costs about $150, but the book by Moore et al. is substantially more comprehensive: Principles of Trauma Surgery has 448 pages and uses a relatively capacious 10-point typeface, whereas Trauma has slightly more than 1000 pages in a smaller 8-point typeface. Moylan covers this whole topic o f trauma care in only 22 chapters, each averaging about 20 pages. Moore et al. uses 63 chapters to discuss a whole series of issues-trauma center designation, epidemiology, organ procurement, alcohol and drugs, radiation injury, geriatric trauma, and disaster planning- touched on only in passing or not at all in Moylan's book. I note with concern that Moylan, an expert in burn care, has dealt with the management of thermal injury in Chapter 17, but in so doing significantly duplicates the commentary of Pruitt and Goodwin in their chapter on wound care. Similar repetition is evident; for example many of Meyer's comments on critical care repeat those made in other chapters. Up-to-date references are critical for a text. The turnaround time for a new textbook is about 18 months, and none can be expected to have references more recent than 2 years before publication. On the other hand, in a field as rapidly changing as trauma care, at least some of the references ought to be contemporary. Unfortunately, only one c h a p t e r - o n splenic trauma by McCarthy and G l o v e r - really meets this requisite in Principles of Trauma Surgery. In fact, with only a few exceptions among the text's hundreds of references, the most recent citations are from 1985 or, rarely, 1986. Most of these chapters were written by the same authors as in Moylan's first edition in 1988 and contain few if any updated references. McCann and Makhoul present a workmanlike 20-page review of vascular trauma (Moore et al. allot three chapters and 60 pages), but except for a pair of their own case reports in the JOURNAL OF VASCULAR SURGERY,they provide few references more recent than 1 9 8 3 - a n d none since 1986. They dismiss compartmental hypertension and recent investigations into its pathophysiology in less than a paragraph. The reader will look in vain for answers to questions such as the following: "Can I use a synthetic graft in case of penetrating vascular trauma?" "Is there a role for