Getting one's first copy of Harrison's Principles of Internal Medicine has been a rite of passage for medical students for years, and it continues to be an essential reference for many. Harrison's Pulmonary and Critical Care Medicine is one of a series of 9 specialty paperbacks now offered by the editors of Harrison's Principles of Internal Medicine, which also include texts on infectious diseases, hematology and oncology, and cardiovascular medicine. Harrison's Pulmonary and Critical Care Medicine includes the relevant chapters from the 17th edition of Harrison's Principles of Internal Medicine, along with review questions from the 17th edition of Harrison's Principles of Internal Medicine Self-Assessment and Board Review, with updated references.
The editor and chapter authors are international experts in the field. Meant to serve as an overview of the field of pulmonary and critical care medicine and emphasize the importance to the field of internal medicine, the preface states that the book is designed for “physicians in training, medical students, practicing clinicians, and other health professionals.” Medical students and physicians early in their training will probably find this book the most useful, as it truly is an overview of the epidemiology, pathophysiology, clinical manifestation, and management of the broad array of respiratory diseases and critical care medicine. Pulmonary and critical care specialists may find it insufficiently detailed for their needs, and respiratory therapists and nurses may want more practical information and evidence-based recommendations.
The text is divided into 5 sections: “Diagnosis of Respiratory Disorders,” “Diseases of the Respiratory System,” “General Approach to the Critically Ill Patient,” “Common Critical Illnesses and Syndromes,” and “Disorders Complicating Critical Illness and Their Management.” The first section serves as an introduction, with a chapter on the approach to patients with respiratory diseases, followed by symptom-based chapters, such as cough and hemoptysis, and concludes with chapters on diagnostic procedures and chest imaging. Each of the next 4 sections focuses on either respiratory diseases or diseases or syndromes associated with critical illness.
There are 45 chapters, and they are consistent in organization and appearance, which makes the book easy to read and visually appealing. Each chapter begins with an outline, making it easy to find specific information; however, the chapters do not include learning objectives. The disease-focused chapters (eg, those on asthma or deep venous thrombosis and pulmonary embolism) include sections on the epidemiology, pathophysiology, clinical manifestations, and treatments. For those who prefer to focus on the “bottom line,” the subsections on treatment are highlighted in light blue and are easy to find. Unfortunately, the treatment recommendations in many chapters (eg, those on severe sepsis and septic shock, and pneumonia) do not distinguish between evidence-based recommendations and those based on expert opinion. The illustrations are brightly colored, clear, and complement the text. Each chapter concludes with a short list of relevant additional readings.
One-hundred fourteen review and self-assessment questions and answers are included at the end of the text. The questions are well written, cover a broad range of pulmonary and critical care topics, and will be useful for readers who are studying for board exams. However, for readers using the book as a reference source, or readers trying to learn the material for the first time who want to test themselves on what they've just read, topic-specific questions at the end of each chapter would be more helpful.
After reading this book, I'm a little uncertain as to what unfilled educational need it meets. The complete Harrison's Principles of Internal Medicine retains it's role in the training of medical students and physicians, and this book is essentially a lighter-weight and more portable repackaging of a portion of the complete Harrison's, with the addition of review questions. It does offer a thorough overview of pulmonary and critical care medicine, yet it is less detailed in both pathophysiology and clinical management than many dedicated pulmonary and critical care textbooks. It is most useful for students; however, early in their training few of them are likely to have a clearly established interest in pulmonary and critical care, and they may be better off getting the complete Harrison's. Practitioners who want a very detailed textbook of pulmonary and critical care medicine will need to look elsewhere.
Footnotes
The author has disclosed no conflicts of interest.
- Copyright © 2011 by Daedalus Enterprises Inc.
