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Critical Care of the Surgical Newborn.
  1. H GRANT, Consultant paediatric surgeon
  1. John Radcliffe Hospital, Oxford

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    Critical Care of the Surgical Newborn. Edited by Don Nakayaman, Carl L Bose, Nancy C Chescher and Robert D Valley.[Pp 610 hardback $150]. Futura Publishing Co, Inc. ISBN 0-87993-653-3.

    “Much study is a weariness of the flesh” stated the writer from Ecclesiastes. The acquisition of medical knowledge requires the consumption of many large, indigestible tomes. This compact textbook on critical care of the surgical newborn provides a suitable antidote. It is small, concise, light in weight, but packs a quality punch. It is a good balance of relevant embryology, antenatal diagnosis, appropriate investigations, and operative management. From a surgical perspective I found the chapters on prenatal diagnosis and ultrasound particularly useful, teaching me many things I probably ought to have known already.

    It covers the usual range of child topics on neonatal care well and succinctly and in a sufficiently different way to be interesting. It also discusses ethics and anaesthetics and analgesia. The chapter on anaesthetics finally answered a question I have asked every anaesthetist but to which I have never received a satisfactory reply—namely, what is the intraoperative/anaesthetic death rate in babies? The intraoperative death rate quoted of 8.3/1000 for infants under one month seemed more realistic than the optimistic replies from colleagues. The intraoperative death rate of children between one to 12 months of 0.8/1000 seemed higher than I imagined, but will influence what I say to parents when seeking informed consent in the future.

    Unusually for a textbook, it held my interest and attention and was readable and will influence my clinical practice in the future.