Brain Injury and Pediatric Cardiac Surgery

Abstract

Associate Professor and Head, Section on Cardiothoracic Anesthesia, Department of Anesthesia, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157–1009.James C. Eisenach, M.D., EditorBrain Injury and Pediatric Cardiac Surgery. By R.A. Jonas, J.W. Newburger, and J.J. Volpe. Newton, MA, Butterworth-Heinemann, 1996. Pages 416. Price:$125.00.This book, beautifully written and edited, is a definitive text of 28 chapters. In the foreword, Dr. John Kirklin describes it as “authoritative,” with authors making “monumental contributions.” I agree wholeheartedly. The monograph, divided into six subject areas, is a state-of-the-art review that covers basic science and clinical issues that pertain to neurologic outcome for children undergoing cardiac surgery. The sections are arranged as follows: Development of the Central Nervous System; Assessment of CNS Function; Mechanisms of Neurological Injury; Clinical and Laboratory Studies of Cardiopulmonary Bypass, Hypothermia, and Circulatory Arrest; A Prospective Study of Circulatory Arrest at Children's Hospital, Boston; and New Strategies for Cerebral Protection. The only omission I noted was the lack of a discussion of computerized cranial tomography and magnetic resonance imaging, although these techniques are presented in various figures. The language is simple yet eloquent, and even complex molecular biology is presented in a readily comprehensible fashion.The list of authors is a multidisciplinary one, mostly from Children's Hospital in Boston, MA, and Harvard Medical School. Where appropriate, chapters were contributed by experts in the field who are on the faculty of other schools. The editors emphasize interdisciplinary collaboration, with synthesis of knowledge from experimental and clinical models.The book is a convenient size and is printed on high quality, matte paper. Each chapter is well organized, with headings and subheadings. Each contains an ample number of enlightening figures and tables that are well reproduced with informative legends and footnotes. The references provide an in-depth, yet not tedious, background to the material. The index could have been more comprehensive, and so, limits the value of the book as a rapid, off-the-shelf reference.The book may prove to be a useful and comprehensive reference for residents and fellows and deserves a place in the library of every anesthesia training program. It is an essential resource for cardiac surgeons, anesthesiologists, and neurologists who engage in the care of pediatric cardiac surgical patients. For those with an interest in researching brain injury after cardiac surgery, including basic scientists and clinicians, it should be read from cover to cover and absorbed fully.The book price, $125, seems high, but after reviewing it, is worth every cent. I congratulate the editors and contributing authors on a major contribution to the field.Anne T. Rogers, M.B.Ch.B., F.R.C.P., Associate Professor and Head, Section on Cardiothoracic Anesthesia, Department of Anesthesia, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157–1009.