The first edition of Oh's Intensive Care Manual was published in 1979, when intensive care may not have been in its infancy but it certainly wasn't far beyond. Teik Oh, with tremendous foresight, brought together the fundamental elements of managing the critically ill in a particularly pragmatic manner, which could be considered a guideline for the development of the specialty. Thirty-four years on, the seventh edition reflects both the maturation of that specialty and the phenomenal progress medically, technically, scientifically, ethically and educationally in all areas of management of the critically ill.
As with previous editions, each and every chapter has been updated, and there are many areas where new sections reflect the changing nature of the specialty and the subtle shifts in emphasis in the workplace. These include the growing interest in critical care both before and after the intensive care unit, including the role of palliative care. There is increasing focus on the ethical dilemmas, which cannot be separated from legal considerations that beset critical care in all age groups. Team working is fundamental to delivering intensive care and this is formally addressed, as is education and examination. As bedside ultrasound has been incorporated into clinical examination and many procedures, this is now recognised in addition to the chapter on echocardiography. Extracorporeal membrane oxygenation (ECMO) is increasingly being used for both respiratory and circulatory support, with a unique double chapter dedicated to this area. Almost every chapter has new developments while in some, such as liver failure, there are new sections to address the increasing complexity of the field as it impacts on intensive care. Malignant disease is a common co-morbidity or cause for admission postoperatively so this has been included, as has delirium, which is a common problem.
There has been discussion about the relevance of the paediatric section in this era of specialisation. It is the editors' contention that populations outside of hospital include paediatrics and so a working knowledge of paediatric intensive care should be an integral part of any intensivist's knowledge. With this in mind, this section has been significantly, and in our opinion impressively, updated.
We sincerely hope that this edition will achieve several goals. It will update the previous edition in terms of the changing knowledge base, it will address emerging issues in intensive care, it will be of use to both medical and paramedical staff, but most importantly it will adhere to the pragmatic and clinically useful style so effectively promulgated by Teik Oh when it was originally published 34 years ago. If clinicians can reach for it in the early hours of the morning, easily locate the information they require and feel either guided or reassured, it will have served its purpose. If those passing examinations can say it helped, that would be gilding the lily.