SECTION EDITOR

NORIG ELLISON

Book and Multimedia Reviews

Ohs Intensive Care Manual, 5th Edition, A.D.
Bersten & N. Soni, Butterworth Heinmann, 2003
Andrew D. Bersten and Neil Soni, eds. Boston: ButterworthHeinemann (an imprint of Elsevier Science Limited), 2003. ISBN
0-7506-5184-0. 1176 pp, $79.95.
The textbook market for physicians training in critical care consists
principally of two categories, small pocket manuals and large encyclopedic textbooks. For some time, a medium-sized but comprehensive tome to recommend to residents and fellows has been
needed. The new edition of Teik Ohs Intensive Care Manual, which
has long been the favorite text of critical care trainees outside the
United States, meets this need.
The new edition, edited by Andrew Bersten and Neil Soni, is
written by a veritable whos who of British and Australian intensivists. The book is divided into 100 or so medium-sized, easily
digested chapters that are organized into 17 sections, covering
the whole spectrum of critical care, from the design and organization of intensive care units through infections and supportive
care to environmental injuries. New chapters have been added
addressing topical issues such as ethics, post-ICU problems and
biologic terrorism. Unlike many competing texts, Ohs Intensive
Care Manual addresses cardiac care, pediatric critical care, and
obstetric emergencies. The chapter on hemodynamic monitoring
is especially outstanding. One of the books great strengths is the
coverage of broader issues in critical care, such as poisoning,
hematology, trauma, hypothermia, and electrocution. The chapters on donor preparation and transplantation are particularly
useful, being poorly covered elsewhere. The chapter on envenomation (snake bites) is especially enjoyable.
The Intensive Care Manual, running at 1100 pages, is undoubtedly the most comprehensive, concise textbook of critical care
medicine available. However, the structure of the book also leads
to some drawbacks. The practice of intensive care medicine is
dominated by shock, fluid balance, sepsis, and respiratory failure. Yet the space allocated to these problems is the same as that
given to HIV and plasma exchange. We were particularly disappointed with the chapters on respiratory failure, which, like the
majority of publications, describes modes of ventilation rather
than ventilation strategies. Surprisingly, there is no chapter on
ventilator liberation, or failed weaning, a major problem in critical care. Likewise, the neuroendocrine response to critical illness
receives little mention. The lack of reference to the physiochemical (Stewart) approach to acid base balance, a highly topical
subject in the critical care literature, was surprising, as was the
failure to address the importance of the topical issue of ventricular interdependence and right ventricular dysfunction.
These limitations, nevertheless, should not deter the reader. The
book is a remarkably easy read, with chapters organized into subsections using bulleted lists and thoughtful diagrams and tables.
With its soft cover the manual is highly portable, and the majority
of chapters can be read in a single session. This makes the book an
ideal companion for a night on call.
In conclusion, Ohs Intensive Care Manual is an excellent text for
those who need a comprehensive review of all aspects of critical
care. As a review book for the Critical Care Boards, with its size
and readability, this book is peerless. While more focus on the
clinical approach to critically ill patients is recommended for
future editions, these reviewers will happily recommend this
edition to their residents and fellows.
2004 by the International Anesthesia Research Society

Patrick Neligan, MB, BcH, FCARCSI

Assistant Professor

Clifford Deutschman, MS, MD, FCCM

Professor
Department of Anesthesia
University of Pennsylvania
Philadelphia, PA

Anesthesia for Oral and Maxillofacial Surgery

(Vol.41, No. 3, International Anesthesiology Clinics)
A. Herlich, ed. Philadelphia: Lippincott Williams & Wilkins, 2003.
ISBN 0020-5907. 157 pp, $260.00 annual subscription for 4 issues.
This is a very interesting book; however, it does not discuss the
usual concerns in oral and maxillofacial surgery. Rather than extensive discussions of the difficult airway, even in the chapter on
Anesthetic Techniques for Oral and Maxillofacial Surgery, the
book seems to be concerned with proving that office-based anesthesia without anesthesiologists is safe, and that the surgeonanesthetist is a role model worth adapting in other surgical specialties. The chapter entitled Anesthesiologists and the Education of
Dentists (and others) in Anesthesia is an interesting look, both
historical and current, at the training of dentists in anesthesia.
The best part of this issue of International Anesthesiology Clinics is the
historical introduction of the topic under consideration. The initial
chapter, The Art and Science of Office-Based Anesthesia in Dentistry:
A 150-Year History sets the tone for the rest of the book. The historical
facts are accurate and interesting, and the essay well written. Yet, the
interpretation of the historical material bias the reader toward believing that dentistry has played a larger role in the history of anesthesiology than may be the actual case. The chapter on the laryngeal mask
airway is equally interesting. For a device first designed in 1981 and
commercially available in the US in 1991, it has diverged into five
different devices, all with their own niche in airway management. The
author does a wonderful job in describing the differences between
LMAs and their specific roles in anesthesia. This chapter is in some
ways the definitive discourse on the device.
The most interesting chapter in the book is the last one, entitled
Oral and Craniofacial Pain: Diagnosis, Pathophysiology and Treatment. The authors trace the common painful conditions of the
head, their origins and treatments. It makes for interesting reading
for those interested in pain medicine. It was also helpful for understanding some of the operating room procedures used to eliminate
these conditions. The other fascinating chapter for anesthesia educators was Education in Dental Anesthesia. Clearly and concisely
written, the author identifies the anesthesia requirements of dental
and oral maxillofacial programs. There are several good explanations about how these anesthesia criteria were established, and
several of the organizations that issue credentials in dental anesthesia are identified. This is mandatory reading for those hospital
anesthesia chairs responsible by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) for anesthesia and
sedation outside the operating room. It will help weed out the
various credentialing agencies.
Overall, this is an interesting tome on oral and maxillofacial
anesthesia from the dental perspective. Outside of its somewhat
subtle political overtones, this issue contains interesting information
that has not been readily available to the average anesthesiologist.
Douglas R. Bacon, MD, MA
Professor of Anesthesiology and Medical History
Mayo Clinic College of Medicine
Rochester, MN
Anesth Analg 2004;98:879

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