Book Review

Critical Heart Disease in Infants and Children

N Engl J Med 1995; 333:741September 14, 1995

Article

Critical Heart Disease in Infants and Children
Edited by David G. Nichols, Duke E. Cameron, William J. Greeley, Dorothy G. Lappe, Ross M. Ungerleider, and Randall C. Wetzel. 1069 pp., illustrated. St. Louis, Mosby, 1995. $149. ISBN: 0-8016-6929-4

Critical Heart Disease in Infants and Children emphasizes the basic principles surrounding the postoperative intensive care of children who have congenital heart disease. The authors come from many disciplines, including anesthesiology, nursing, pediatric cardiology, pediatric cardiothoracic surgery, critical care, nutrition, and other related specialty areas. This multidisciplinary emphasis parallels the composition of management teams in successful critical care settings and makes the book stronger than if it had been written by members of any one area of emphasis.

The book's several sections include basic principles, problems unique to the critical care setting, equipment and techniques, congenital heart defects, and general medical conditions. I found the sections on basic principles, special problems, and equipment and techniques to be among the best written and most informative of any material I have seen on these subjects, especially as regards the critical care setting. These particular sections are not only germane to the narrow area of postoperative cardiovascular care but are also worthwhile reading for anyone working in the critical care environment. The sections on congenital heart defects and medical conditions were of variable value. Most, if not all, of this material is available in greater detail in other standard pediatric cardiology textbooks. Some of these chapters lost sight of the intent of the book — that is, to focus on critical care — and were more generally descriptive of chronic conditions or of operative techniques that were interesting but not necessarily relevant to the book's subject.

General criticisms about the book fall on the publishers rather than the editors. These include the alphabetical, rather than numerical, referencing, which creates some clumsiness in looking up a specific article. The figures that show echocardiograms, angiocardiograms, and chest films generally lack adequate contrast, and sometimes poorly display what otherwise appear to be excellent selections but which are difficult to evaluate as published. The textbook is large and the binding is fairly loose, which leads one to question its durability.

In comparison with other textbooks on pediatric cardiology, this one stands out because of its emphasis on critical care. This feature applies especially to the first few sections, which should be required reading for every cardiology fellow and attending physician who participates in the intensive care of patients with cardiac disease. Other users of the book should include intensivists, cardiothoracic surgeons, and other specialists who participate in the postoperative treatment of children who have heart disease. Although it will not be useful for practicing primary care physicians, it will serve well as a good basic textbook for medical students and general pediatric residents who are learning intensive care management. Every training program in pediatric cardiology should have at least one copy of this book available to its staff and trainees.

Hugh D. Allen, M.D.
Ohio State University, Columbus, OH 43205