David J. Pierson and Robert M. Kacmarek; eds. 1306 pages. New York: Churchill Livingstone; 1992. $89.95.

What is one to do with a 1306-page compendium of respiratory disease? In the case of this book, the answer is: Use it with ease and pleasure. Pierson and Kacmarek have ably pieced together a well-written, well-illustrated, and remarkably concise text. Whereas several other texts address the same issues, this is the best of the recent lot. Although 54 authors contributed to this text, 51 of the 105 chapters are either authored or coauthored by the editors. This results in a more cohesive whole than might otherwise be seen in a multiauthored book.

The text is divided into 5 sections: Respiratory Structure and Function; Pathophysiology: How Disease Affects the Cardiorespiratory System; Assessment of Respiratory Function and Diagnostic Techniques; Clinical Approach to the Patient with Respiratory Disease; and Respiratory Care Practice. This division is not at all artificial. The first section is composed of 20 brief chapters that average three to four pages each. They are eminently readable. The editors seem to have purposely designed this section to cover the essentials of pulmonary physiology in a manner that is detailed without being inclusive to the point of nonutility. Even an area as difficult as the immunology of the pulmonary system is well done. Although some readers might have initial difficulty with, for example, the discussion of the adult respiratory distress syndrome, which is covered in two separate sections (the pathophysiology in one and treatment in another), one comes to appreciate the structure as the book is used. Also well covered are the more mundane but clinically important areas such as the intubated patient, mouth care, cuff maintenance, and emergency situations involving artificial airways.

I wish some areas had been developed a bit more. The discussion of pressure control (pressure preset) ventilation is inadequate. This mode of ventilation is being used more frequently but is mentioned almost in passing in this text. Coverage of breathing is generally well done. However, the topic is discussed in more than one section, making it difficult to locate information. Despite these few shortcomings, Pierson and Kacmarek have done a fine job. It belongs not only on the shelves of intensivists, pulmonologists, and anesthesiologists, but on those of generalists as well.