Intensive Care Medicine in 10 Years
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BOOKS,FILMS,TAPES &SOFTWARE are difficult to read, the editing is inconsis- tory for critical care medicine. The book is initiate a planning process for leaders who tent, and the content that was omitted indi- divided into sections entitled “Setting the recognize the imperative for change and ad- cates that “efforts to bring this work from Stage,” “Diagnostic, Therapeutic, and In- aptation in critical care. Accordingly, I rec- conception to fruition in less than one year” formation Technologies 10 Years From ommend this book to individuals and groups (as stated in the book’s acknowledgments Now,” “How Might Critical Care Medicine engaged in all aspects of critical care man- section) prevented this book from being a Be Organized and Regulated?” “Training,” agement, now and in the future. “gold standard” text. and “The Critical Care Agenda.” Each sec- J Christopher Farmer MD tion consists of a series of essays/chapters Marie E Steiner MD MSc Department of Medicine that discuss various aspects of the topic, and Department of Pediatrics Mayo Clinic all the sections have solid scientific support Divisions of Pulmonary/ Rochester, Minnesota and bibliographies. The individual topics Critical Care and Hematology/ span the entire range of critical-care clinical Oncology/Blood and Marrow The author reports no conflict of interest related practice, administration, quality and safety, Transplantation to the content of this book review. and so forth. The contributors are acknowl- University Children’s Hospital, Fairview edged senior clinical and scientific leaders University of Minnesota Mechanical Ventilation: Physiological in critical care medicine from around the Minneapolis, Minnesota and Clinical Applications, 4th edition. Su- world. san P Pilbeam MSc RRT FAARC and James The “Setting the Stage” section includes The author reports no conflict of interest related M Cairo PhD RRT FAARC. St Louis: to the content of this book review. “Managing and Leading in Critical Care,” Mosby/Elsevier. 2006. Soft cover, illus- “Critical Care From 50,000 Feet,” “Expec- trated, 651 pages, $58.95. Intensive Care Medicine in 10 Years. tations Around Critical Care: 10 Years On,” Mitchell P Fink, Peter M Suter, William J “The Quality and Safety Agenda in Critical As respiratory therapists and many other Sibbald, editors. Update in Intensive Care Care Medicine,” “The Challenge of Emerg- health care professionals know, some of the and Emergency Medicine series, volume 43, ing Infections and Progressive Antibiotic most complex patient care involves mechan- Jean-Louis Vincent, series editor. Berlin: Resistance,” “Technology Assessment,” and ical ventilation, both invasive and noninva- Springer-Verlag. 2006. Hard cover, illus- “Trends in Pediatric and Neonatal Critical sive. This is true throughout intensive care trated, 435 pages, $179. Care in the Next 10 Years.” Each of the units, rehabilitation centers, skilled nursing sections displays similar depth, quality of facilities, within patient’s homes, and dur- The responsibilities of a capable critical- authorship, and provocative subject matter. ing patient transport. Mechanical ventilation care leader extend beyond clinical knowl- Most essays/chapters are excellently writ- is an essential, life-sustaining measure for edge at the bedside. Critical care is distin- ten, although a few are only average—where many patients, but it can also harm the pa- guished by the absolute need for its clinical the sizzle of the title and substance of the tient. Mechanical Ventilation: Physiolog- leaders to understand and practice interdis- chapter are perhaps about equal. On bal- ical and Clinical Applications, now in its ciplinary teamwork, and to be knowledge- ance, excellent chapters outnumber average 4th edition, is a well-recognized textbook able about systems of care delivery, work- chapters by about 4 to one (there are 31 that has served the respiratory care profes- flow dynamics, budget and resource chapters). In particular, I found the section sion for the past 20 years. The authors do an management, workforce issues, and perfor- on critical care organization and regulation excellent job of taking the reader on a de- mance and quality measurement. In addi- most useful. It addresses hospital and med- tailed, evidence-based journey through the tion, because of an aging population, an in- ical school organization of critical care ser- complexities of mechanically ventilating creasing number of debilitated people with vices, intensive-care-unit physician staffing, and caring for critically ill patients. “long-term” end-organ-failures, and increas- research, conducting outcomes investiga- In general, the sequence of the chapters ing numbers of immunocompromised pa- tions (really, it’s population health research mirrors the general course that many pa- tients, we are witnessing the emergence of for critical care), funding and accounting tients follow: initiating ventilation, manag- critical illness as a chronic disease(s). What structures, and other topics. ingthecourseoftreatments,addressingcom- does this mean to the future practice of crit- Here at Mayo Clinic, like many (perhaps plications, weaning, and liberation from the ical care? Clearly there are more questions most) other critical care enterprises, we are ventilator. The authors thus create a “famil- than answers to this not-so-rhetorical query. at a crossroads, a nexus point. We are ac- iar flow” that is easy to follow, as well as Where does one start? How does one begin tively planning our future critical care de- making the book a reference in which to planning for this uncertain future? livery models based on the immutable real- find specific content on many aspects of Springer-Verlag, under the editorial guid- ities of chronic critical illness, cost, patient mechanical ventilation. ance of Jean-Louis Vincent, publishes a se- volumes, the need for data visibility, safety, The text has 8 parts and 23 content-heavy ries called Updates in Intensive Care and medical simulation, etc. I have shared this and extensively referenced chapters. The Emergency Medicine, and Fink, Suter, and book with some of my fellow colleagues chapters are highly organized, and each in- Sibbald have guest-edited Intensive Care and leaders in critical care, because it is cludes an outline, key terms, and learning in 10 Years as volume 43 of this series. provocative, offers a number of fresh ideas, objectives, thus creating a clear, consistent Their intent was to use the development of and conceptually lays out several pertinent/ road map for the reader. The typeface is intensive care over the last thirty years, as useful concepts in charts, diagrams, and ta- clear and easy to read. The single-color well as the current, evolving demands, as bles. This is not a clinical book, per se, but (green) and black-and-white illustrations are data points to plot a plausible future trajec- rather a book that may facilitate or help clear and relevant to the topics discussed. RESPIRATORY CARE • MARCH 2007 VOL 52 NO 3 347.