1. Gibson, Susan BSN, RN

Article Content

Perinatal and Pediatric Respiratory Care, 2nd ed, by Michael P. Czervinske and Sherry L. Barnhart. St. Louis, Mo: Saunders; 2003. 723 pages, hard cover.


For neonatal and pediatric nurses who work with children compromised in any fashion by respiratory distress or disease, this book will be a valuable addition to the library.


This book contains 46 chapters divided into 5 sections. Each chapter includes a thorough and current (within the past ten years) reference list. Section I (chapters 1-4) covers fetal lung development, an excellent review of fetal gas exchange and circulation, antenatal assessment and the high-risk delivery, and neonatal assessment and resuscitation. Chapter 25 exclusively details cardiopulmonary resuscitation as it relates to both the neonate and the older pediatric patient.


Section II (chapters 5-11) proceeds in a chronological fashion as it addresses assessment and monitoring of the neonatal and pediatric patient. Chapters 5 and 6, respectively, provide useful guidelines for assessing the respiratory status of the infant and older child. Diagnostics are included in this section, with a description of pulmonary function tests, bronchoscopy, and radiographic assessment. Nurses who are often uncertain of these procedures and their implications, will find these chapters written in a concise easy-to-understand manner. Chapter 8 is very helpful in describing chest x-rays and providing clear, delineated examples of various respiratory disorders. The remainder of this section discusses various methods of monitoring respiratory status, such as cardiovascular monitoring, noninvasive monitoring, and an excellent review of blood gas analysis.


Section III (chapters 12-27) continues with therapeutic procedures for treatment of neonatal and pediatric disorders. These chapters are laid out in a progressive fashion, beginning with oxygen administration, airway management, airway clearance methods, and lung expansion techniques. The text continues with chapters that involve more complex respiratory disorders and more invasive management such as continuous positive airway pressure (CPAP), intubation, surfactant replacement, and mechanical ventilation. The book does an outstanding job in describing the various modes of mechanical ventilation and the implications for choosing which mode for which patient need. As neonatal intensive care units (NICUs) receive smaller and less mature infants, the understanding of how each mode of ventilation works is imperative for NICU nurses who care for these fragile neonates. For example, a minute change in volume or pressure can be either helpful or detrimental in these babies. This book provides the information necessary for the nurse to think critically about her patient as it provides both the physiology and the rationale for treatment modalities all in one resource.


Section III continues with chapters 21 to 24 describing more advanced technologies that are currently being used in some centers, some that are in experimental stages, and treatments that are hypothetical and on the horizon. The chapter on high-frequency ventilation (21) is very informative and will surely clear any misunderstandings one may have about this treatment. Liquid ventilation and administration of other gas mixtures was explained in chapters 22 and 23 respectively. Chapter 24 is devoted to Extracorporeal Life Support and offers an excellent description of the mechanisms involved and the implications for its use in both the neonatal and pediatric populations. Chapter 27 describes thoracic organ transplantation. One can see with the progression of treatment options described in this book that there is a reference for nurses who work with mildly affected infants and children to those who work with the more complex and severe conditions. Chapter 26 provides a great resource of pharmacologic agents used in respiratory management.


Section IV (chapters 28-44) elaborates on neonatal and pediatric respiratory disorders; their presentation, diagnosis, and treatment. New insights can be gained from these chapters as they address neonatal pulmonary disorders, congenital and surgical disorders that affect respiratory care, and complications of neonatal care. Chapter 31 offers an excellent overview of congenital cardiac defects. Other topics of interest included in this section are sudden infant death syndrome and pediatric sleep disorders, asthma, cystic fibrosis, head injury and cerebral disorders, drowning injury, pediatric poisoning as well as disorders of the neurologic and neuromuscular systems.


Section V (chapters 45-46) looks at neonatal and pediatric transport and home care. These avenues present unique challenges in respiratory care but ones that need to be addressed as regionalization and early discharge become more prevalent.


Neonatal nurses who work in levels I, II, III, and IV nurseries can all glean valuable information applicable to their patient care. Pediatric nurses will find this resource valuable as it relates to the respiratory needs of their patients. The strengths of this book include relatively short chapters with concise information and an excellent reference list at the end of each chapter; many diagrams and figures to help incorporate the written information into another learning method; and many photos and pictures of x-rays to give the reader a visual of the subject matter. In summary, as stated previously, this book will be a valuable addition to any neonatal and pediatric nurse's library.