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Doody's Review ServiceReviewer: David J. Dries, MD (University of Minnesota Medical School)
Description: This handbook describes interpretation of data obtained from the pulmonary artery catheter in various states of acute cardiac dysfunction.
Purpose: The author reviews time-tested physiologic principles underlying hemodynamic monitoring. This work is described as a platform for the student of cardiovascular medicine. As an overview of a critically important topic, this guide is a valuable contribution.
Audience: The student, house officer, and practitioner of cardiovascular medicine will value this handbook. The author works in the Coronary Care Unit at the Hennepin County Medical Center in Minnesota.
Features: Fourteen chapters and two appendixes are included in the 200 pages of this manual. Normal physiology is described in the first several chapters, followed by a variety of acute hemodynamic derangements, including tricuspid regurgitation, left and right ventricular infarction, congestive heart failure, pericardial tamponade, cardiomyopathy, and pulmonary embolism. Chapters are amply embellished by black-and-white illustrations of pressure tracings and tables summarizing key points. A reference list of 10 to 35 items completes each chapter. References date to within several years of publication but include key developments in hemodynamic monitoring. The chapters build on each other and cross referencing is included. The table of contents lists chapters only by name. A subject index with separate citations for figures is also provided.
Assessment: Recent medical literature questions the role of hemodynamic monitoring in the management of the critically ill patient. Another report suggests that many practitioners using the pulmonary artery catheter do so in a manner inconsistent with established standards. The manual provided by Dr. Sharkey should be seen as an essential introduction to the student and trainee in the critical care unit as well as a refresher for the senior practitioner.