the book has excellent summaries of pathophys behind what we see/diagnose/measure/do in the icu. the book does have significant drawbacks, though, namely that it is highly biased towards the author's occasionally contraversial opinions. my attendings (all critical care experts) have debated some of his recommendations. also, with the most recent version published in 1997 (and knowing that the acutal revisions were probably done a year or so before that) the book is 5 years behind the times.in summary, good book for basics, for understanding how and why, for explanations of procedures and basic protocol. be wary of marino's unusual recommendations. be aware of more current recommendations. use other references as well for broader picture.