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Assisted ventilation of the neonate.
  1. SUNIL SINHA, Director
  1. Neonatal Serivces
  2. South Cleveland Hospital, Middlesbrough

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    Assisted ventilation of the neonate. Third Edition. JP Goldsmith et al. (Pp 532; £60 hardback). WB Saunders, 1995

    With progress in neonatal ventilation, there has been a steady rise in the survival of very small infants with respiratory failure. Unfortunately, there has been a parallel increase in acute complications and chronic sequelae which pose a major challenge to neonatologists and paediatricians. The goal of neonatal ventilation should be to provide the most physiological and safe mode of respiratory assistance, without iatrogenic consequences. Many advances have been made recently, both in the concept and application of neonatal assisted ventilation. Clinicians now have the opportunity to use new ventilatory modalities, a trend that is likely to continue.

    The book on neonatal ventilation by Goldsmith has an established reputation as a useful resource. Naturally, I was delighted when this latest edition, the third in 15 years, arrived on my desk. Unfortunately, it falls short of my expectation as it has little to add to what is now common knowledge. I had hoped that, besides providing comprehensive, authoritative, and contemporary discussion on neonatal ventilation, the authors would have defined areas of controversy and lacunae of knowledge, as well as providing opinion on the merits and drawbacks of different aspects of ventilatory management, and identifying future areas of study. The book seems to have suffered from the lack of revision by both authors and editors near the time of publication, as some of the practices outlined in the text, especially those relating to ventilatory modes, have already become outdated. This is a perennial problem in such a rapidly advancing field as neonatology, and should serve as a warning to prospective authors and editors.

    Despite these deficiencies, this book is still the best available monograph on neonatal ventilation, and I would recommend that a copy be available in every neonatal department. After all, mechanical ventilation remains the single most important therapeutic method in neonatal intensive care, and nobody dealing with sick neonates should be left in any doubt about the potential implications of the changes taking place in the management of respiratory failure in neonates.