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Critical Care Pharmacist/Surgical Team Leader/Education Coordinator, Department of Pharmacy, Mount Sinai Hospital, Toronto, ON, Canada
Staff Intensivist, Medical–Surgical Intensive Care Unit, University Health Network and Mount Sinai Hospital
Published Online, August 2, 2005. www.theannals.com, DOI 10.1345/aph.1G048
Format: The material is presented as a hardcover textbook.
Audience: The targeted audience is stated to be "almost anyone who manages patients in a neurological, general, or surgical intensive care setting." The book's primary focus is medical diagnosis and management strategies. Based on the content provided, the intended primary audience appears to be critical care physicians rather than other medical subspecialties and nonphysician healthcare professionals, (eg, pharmacists).
Purpose: The text is based on 2 facts: (1) many ICU clinicians do not know how and when to treat seizures, and (2) literature to help direct management of these patients is often lacking or contradictory. The primary goal of this text is to provide an in-depth review of the etiology, pathophysiology, and treatment of seizures in a variety of critically ill patient types.
Content: There are 14 chapters organized by "type" of ICU patient (eg, stroke, organ transplantation); chapters are further neatly divided into subheadings. For example, the stroke chapter is broken down into seizures after ischemic stroke, intracerebral and subarachnoid hemorrhages, arteriovenous malformations, reperfusion–hyperperfusion syndrome, and cerebral venous/dural sinus thrombosis. This organization allows the reader to readily find specific appropriate information, as etiologies and treatments vary according to the primary reason for critical care admission. The content is accurate, complete, and current. There is some variability between authors on the details of treatment; namely, some chapters provide drug doses, while others just mention the drug name. Detailed pharmacotherapy would extend the usability of the text by pharmacists.
Usability: References are extensive and recent. The price of the book is somewhat expensive at $125, considering that a CD-ROM or PDA version is not provided.
Highlights: The strength of this book lies with its organization of information into a readily accessible format based on a variety of critical care scenarios. The chapters are well written by world experts. The content targets the majority of critical care admissions, will assist clinicians in determining the cause of a seizure, and provides a framework for treatment.
Limitations: The book's main limitation is the overutilization of electroencephalography (EEG) tracings without adequate labeling. It may be difficult for a non-neurointensivist to determine abnormal from normal tracings as there are no arrows to indicate the abnormalities on the tracing. Similar problems exist with the use of magnetic resonance and other imaging.
Summary: Our overall impression of this text is very positive. We recommend this book as a resource for any ICU, as it is the first text to specifically review seizures in the critical care setting, but we are not inclined to recommend it for every intensivist's library. We recommend that future editions reduce the extensive use of unlabeled EEG tracings and increase pharmacotherapy details.
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