Artificial nutrition support in clinical practice. (Book Reviews).

Payne-James J, Grimble G, Silk D (editors)

Greenwich Medical Media Ltd., London, 2001, 798 pages, $440.00, ISBN 1-90015-197-9

The practising clinical nutritionist, dietitian or physician, is faced with large time demands to keep up with the clinical nutrition literature. Keeping and reading professional textbooks, which may date reasonably rapidly, form one part of the response to this time demand. Most of the major textbooks on nutrition support practice in recent times come from North America, with its particular slant on practice including indications and costs, which sometimes seem remote from Australian practice. This textbook presents a European perspective, emanating from British editors, but with chapter authors from western Europe, the UK and a leavening from the USA. Authors have medical, dietetic, science, nursing and pharmacy backgrounds. It is likely therefore, that this book will be a little closer to general Australian practice and standards in nutrition support, and so compare well with the other textbooks in this area.

This book represents a second edition from what started out over a decade ago as a small pocketbook, and became the basis of a clinical nutrition course manual. It has since blossomed into the current new edition with new basic chapters on cytokine-driven metabolism as a determinant of nutritional requirements, the effect of disease on appetite, and applied chapters on the creative use of hospital catering, pancreatitis, and the cost-effectiveness of nutrition support. Alongside these are the usual topics that cover the whole gamut of nutrition support, mainly within the acute hospital context, but not excluding home support. Clinical topics are largely organised by system disorders, and cover paediatrics and geriatrics.

The book is well illustrated with line diagrams and decision-making flowcharts, alongside punchy paragraph topics suggesting tight overall editorial control. Each chapter concludes with a good, current set of journal references to chapter topics, though these will date reasonably soon. The index is reasonably comprehensive enabling rapid navigation to subtopics. Mercifully, the book is free of appendices.

Reviewers generally have their little areas of great knowledge, and can find problems of detail in most books that they read. I am no exception, and disagreed with some of the statements about body composition measurement techniques, but these are marginal, since no book can be all things to all readers.

This book would be suitable for hospital-based dietitians, particularly those who work only occasionally in nutrition support teams, and so would do well in a department library. Other members of nutrition support teams, such as physicians with an interest in clinical nutrition, pharmacists and nurses, would also glean much, but its cost, as is common for specialist textbooks with limited potential distribution, is high for an individual, and may put it out of reach for nutrition or medical students. A university or hospital biomedical library would, however, find it of value.