Understanding the language of intensive care physicians

The surgical critical care handbook. Guidelines for care of the surgical patient in the ICU.

Jameel Ali, editor. World Scientific, 2016 (756 pp, US$175.00). ISBN 9789814663120

In the United States, surgeons (also known as surgical intensivists) often directly manage patients in the intensive care unit (ICU). Taking this into account, and despite the need to “translate” words such as “epinephrine”, “norepinephrine” and “respirologist”, I approached The surgical critical care handbook as an Australasian surgeon wishing to be conversant in the language of the intensivists to whom I entrust the care of my critically ill patients. In that respect, the book edited by Jameel Ali, Professor of Surgery and Advanced Trauma and Director of the Life Support Program at the University of Toronto, is generally fit for purpose, written in a broadly conversational style by a number of expert contributors. While not overly burdened with levels of evidence or results of randomised controlled trials, sufficient references are nonetheless provided to direct readers to the scientific background or details of operative surgery.

In a conventional conceptual framework, the book comprises two sections. “General considerations” deals largely with the various aspects of management that constitute critical care, including ethical considerations, and also involves a modicum of theoretical underpinning in respiratory physiology. “Specific surgical disorders” is a series of chapters on the pathophysiology, investigation and treatment of traumatic and non-traumatic conditions that require critical care.

The information provided in The surgical critical care handbook is as up-to-date and clinically applicable as it can be. It is reassuring to see mention of issues of increasing topical interest, such as bariatrics, transplantation and iatrogenic coagulopathies. Topics that may have needed a more in-depth discussion include chronic liver disease or liver failure in the surgical patient, major vascular injuries and other vascular pathologies, and penetrating neck trauma. Where relevant, details of surgical procedures in ICU patients are provided in sufficient detail, although the ICU-naive probably would have appreciated some specific chapters on inotropic support and monitoring modalities.

In the Australian setting, this book may be a useful resource for practitioners such as rural generalists. Surgical trainees may also find it a user-friendly aid to examination preparation and as a quick reference for problems encountered in everyday practice.