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The Michigan Manual. A Guide to Neonatal Intensive Care. 2nd edn. Steven M Donn, ed. [Pp 437; $37.50 paperback.] Futura Publishing, 1997. ISBN 0-87993-676-2
Most paediatricians will remember the fear they experienced after their initial exposure to the hight-tech world of neonatal intensive care, especially those graduating in the past decade of rapid technological advancement. Many handbooks available for the new practitioner in this field do not help allay these fears, because they often lack sufficient complexity or practical examples. This is a lesson many of us will have learnt at 3 am during the first week of our jobs.
Fortunately, this book does not fall into that category. It adopts a pragmatic approach to neonatal intensive care, offering suggestions for practice rather than dogma, drawing on many years of experience from a large unit. Chapters follow a logical progression, starting with resuscitation and shock, followed by system disorders and then less acute topics, such as retinopathy, audiology, and follow up. Certain conditions are covered in more detail in separate chapters, such as meconium aspiration syndrome and persistent pulmonary hypertension of the newborn, as are newer treatments such as ECMO and nitric oxide.
Most concepts are illustrated by a useful working example, such as how to calculate sodium deficit or how to make up an inotrope infusion. All chapters are supplemented by a suggested reading list, should further detail be required. Practical procedures are adequately covered, although very few diagrams are included.
The chapter on ventilation is particularly helpful, and treatments are well explained—including the concept of termination sensitivity—with specific advice on how to approach different lung pathologies, and easy to follow algorithms. High frequency ventilation is discussed before conventional ventilation which may be confusing to the uninitiated, and there is a little too much discussion of the minutiae of different brands of ventilator. But these are minor criticisms.
Many neonatal texts have a certain inbuilt redundancy, because of the rapidity of change in this environment. This book largely avoids this problem by offering an adequate chunk of basic physiology, sound practical advice, shunning dogma, advising caution in the appraisal of newer treatments, and offering a large enough alternative reading list. We recommend it on the basis that it is one of the better texts on the market for neonatal senior house officers, registrars and nurse practitioners.
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