West’s Respiratory Physiology: The Essentials Tenth Edition
This book was first published 40 years ago and has served several generations of students. It has been translated into 15 languages. This new 10th edition incorporates a number of innovations—the most important is that Andrew Luks, M.D., has come on board as a coauthor. Dr. Luks is a felicitous choice. He obtained his M.D. at the University of California San Diego (UCSD) School of Medicine and therefore took the course for which the book was originally written. In fact, he still has his extensively underlined fifth edition of the book! He has a strong interest in teaching medical students at the University of Washington School of Medicine, and so he is well poised to look after the coming generations.
Another innovation of this new edition are clinical vignettes for each of the first nine chapters of the book. The purpose of these is to emphasize how the physiology that is described in the main text can be used in a clinical
situation. Also 26 new multiple-choice questions have been added. Some of these require more reasoning than the traditional questions that rely heavily on factual recall. Another new development has been the production of fourteen 50 minute lectures closely based on the material in the book. These are freely available on YouTube and have proved to be popular with students.
For example, the first lecture on Structure and Function of the Lung has had over 100,000 visits. The URL is http://meded.ucsd.edu/ifp/jwest/resp_phys/ index.html. Finally, there has been a change in the title of the book consistent with its coming of age.
In spite of these new features, the objectives of the book have not changed. First, the book is intended as an introductory text for medical students and allied health students. As such, it will normally be used in conjunction with a course of lectures, and this is the case at UCSD. Indeed, the first edition was written because I believed that there was no appropriate textbook at that time to accompany the first-year physiology course.
Second, the book is written as a review for residents and fellows in such areas as pulmonary medicine, anesthesiology, and internal medicine, particularly to help them prepare for licensing and other examinations. Here, the requirements are somewhat different. The reader is familiar with the general area but needs to have his or her memory jogged on various points, and the many didactic diagrams are particularly important.
It might be useful to add a word or two about how the book meshes with the lectures to the first-year medical students at UCSD. We are limited to about twelve 50-minute lectures on respiratory physiology supplemented by two laboratory demonstrations, three small discussion groups, and a review session with the whole class present. The lectures follow the individual chapters of the book closely, with most chapters corresponding to a single lecture. The exceptions are that Chapter 5 has two lectures (one on normal gas exchange, hypoventilation, and shunt; another on the difficult topic of venti lation-perfusion relationships); Chapter 6 has two lectures (one on blood-gas transport and another on acid-base balance); Chapter 7 has two lectures (on statics and dynamics). There is no lecture on Chapter 10, “Tests of Pulmonary Function,” because this is not part of the core course. It is included partly for interest and partly because of its importance to people who work in pulmonary function laboratories.
The present edition has been updated in many areas including blood flow and metabolism, gas transport by the blood, and the physiology of high altitude. Appendix B contains discussions of the answers to the questions including the new questions appended to the clinical vignettes. There are several animations expanding sections of the text, and these are indicated by the symbol . Great efforts have been made to keep the book lean in spite of enormous temptations to fatten it. Occasionally, medical students wonder if the book is too superficial. Not so. If pulmonary fellows beginning their training in intensive care units fully understood all the material on gas exchange and mechanics, the world would be a better place.
Many students and teachers have written to query statements in the book or to make suggestions for improvements. We respond personally to every point that is raised and much appreciate the input.
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|November 26, 2021|
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