Edited by: Andrew Klein, Alain Vuylsteke & Samer A M Nashef

Hardback cover - 420 pages. B&W and colour illustrations

64 Chapters in 7 Sections

Publisher: Cambridge University Press

ISBN: 978-0-521-87283-6
Price:  £45.00 / €65.00

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Cardiac intensive care is a peculiarity in the UK in many hospitals it is the only single specialty critical care area. We shouldn't be too surprised at this, cardiac disease is common and its frequency has spawned many new and innovative treatments. Changes in the organisation of our hospitals may mean more patients with cardiac disease are treated in specialist centres and even fewer seen in general intensive care units thus reducing the skill base and so comfort of many intensivists in managing these patients. Patients don't just present with heart disease they also require surgery for other problems and familiarity with cardiac support is essential for all who work in general units.

This is not an in depth tome but rather a practical text full of the kind of tricks of the trade which make a skilled cardiac intensivist. One potential problem of a single specialty unit is a tendency to 'forget' about the other systems, these are all addressed here along with other essential elements such as ethics and the running of a successful unit.

This is a welcome text targeting a multidisciplinary audience. It will be useful for those approaching an attachment to a cardiac unit but also for those of us outside who want to update ourselves on the latest treatments available.

Dr Anna Batchlor, MB ChB FRCA
Consultant in Intensive Care Medicine and Anaesthesia, Royal Victoria Infirmary, Newcastle, UK
President, The Intensive Care Society

In a corner, a patient is recovering well after a herat operation. Even so, the lights of five infusion pumps are blinking regularly, the ventilator is sighing, the ECG, several pressures, temperature and oxygen saturation are continuosly displays and massive amounts of data are being generated and recorded, and this is when things are going well!

Elsewhere, another patient may be on an intra-aortic balloon pump, a third may be on haemofiltration, a fourth may be on a ventricular assist device and occasionally, behind drawn curtains, a 'mad-eyed' surgeon may be performing open-heart surgery on the unit due to unexpected complications.

The cardiothoracic critical care area can be a frightening place indeed.

Managing the critically ill cardiothoracic patient is no different from any other patient. The principles of good clinical practice apply here as they do elsewhere. Knowing the history helps. Clinical examination, as in every field of medicine, yields valuable information.

However, critical care provides additional, hard clinical data like no other area of medical practice. Continuous and regular monitoring of physiological and haematological parameters makes most diagnoses easy to make. If there is still doubt about the status of the patient, further information is easy to obtain, whether by pulmonary artery flotation catheter, transoesophageal echo or CT scan. This is one area where most decisions are made on the basis of sound evidence rather on a clinical hunch. All that is required is some basic knowledge, a degree of thoroughness and sound judgment.

This book aims to guide carers from all disciplines in the management of cardiothoracic patients during their time in the critical care environment. The work is not exhaustive nor, we hope, exhausting. It is written by experts in their fields and its primary aims are to explain and demystify the approach to various areas of cardiothoracic critical care.

We truly believe the topic of cardiothroacic critical care can be accessible and easy to learn. We hope, with this book, to have made it more so.