A Practical Approach to Cardiac Anesthesia, 2nd ed (1996)

A Practical Approach to Cardiac Anesthesia, 2nd ed. F. A. Hensley, Jr. and D. E. Martin, eds. Boston: Little, Brown and Company, 1995, ISBN-0-316-35786-3, 713 pp, $59.95. The first edition of A Practical Approach to Cardiac Anesthesia quickly became popular with residents in cardiothoracic anesthesia all over the world. One reason was the handy size that made it a convenient reference during clinical work. The main reason for its popularity, however, was the amount of essential information presented in a single volume. The expectations for the second edition were accordingly set high. This second edition is well organized and covers more topics than the first edition. While the first edition was a "handbook" giving easy access to cardiothoracic anesthesia, the second edition is a more extensive textbook covering the field. The exterior of the book has also changed; it no longer fits into the coat pocket, although the number of pages has decreased from 759 to 713. The two editors have used the expertise of 48 co-authors to prepare the 26 chapters of the book. The book is divided into four sections. These sections include I: Anesthetic Management for Cardiac Surgery, II: Anesthetic Management for Specific Cardiac Disorders, III: Circulatory Support and Organ Preservation, and IV: Thoracic Anesthesia and Pain Management. The chapter on cardiovascular drugs has been extended to cover the latest treatment modalities. The management of anesthesia in patients with specific cardiovascular disorders is thoroughly discussed in Part II. The chapter on coagulation management during and after cardiopulmonary bypass gives an updated review on heparinization and neutralization as well as management of postbypass bleeding. Part III deals with mechanical circulatory support as well as strategies for brain protection. In Part IV, thoracic surgical procedures such as thoracoscopy are addressed. All sections and chapters give the reader practical guidelines and discuss basic physiologic and pathophysiologic mechanisms involved. The book thus covers most of the aspects of cardiac anesthesia that are needed for resident and specialist-training and is also a very valuable updated reference for the experienced practitioner in cardiac anesthesia. Of importance for the daily user is the extensive and detailed index, which is easy to use. This textbook has emphasized the pre-, intra-, and immediate postoperative periods. It does not, however, cover equally well the problems that might appear in the late postoperative phase (after 24 h). Many anesthesiologists are also responsible for postoperative care and thus would welcome more detailed discussions on intensive care topics. Another small "problem" with the book is the extensive division, subdivision, and sub-subdivision of the different chapters. Although the divisions are meant to help the reader, in this reviewer's opinion this very rigid system is complex and sometimes tiresome for the reader. This textbook is extensive although moderate in size. The reader is provided updated information and arguments for practical patients care. Clearly, the second edition of A Practical Approach to Cardiac Anesthesia should be available in all departments where cardiac anesthesia is carried out. Mai-Elin Koller, MD, PhD Department of Anaesthesia and Intensive Care Haukeland Hospital University of Bergen Bergen, Norway N-5021