Cardiopulmonary Bypass

Abstract

The editors of this book have endeavoured to produce an easily readable source of information for everyday clinical perfusion practice, and, hence, fill the gap between chapters on perfusion in comprehensive textbooks on cardiac surgery or anaesthesia and large reference works on perfusion science. The target readership ranges from newcomers to the subject from various healthcare disciplines, through to experienced practitioners involved in the delivery of cardiac surgical services. The book is divided into 15 chapters, many written by distinguished practitioners and researchers from both the UK and the USA. Spelling is American English throughout. The sequence of the early chapters runs reasonably logically from considerations of the equipment used for cardiopulmonary bypass, through circuit set-up and priming, anticoagulation, and the conduct and management of bypass. I found the first two chapters slightly irritating. Some of the terms used here are not defined—the newcomer may well ask what an ‘arterial pump boot’ is on page 2, or what ‘full flow’ means on page 6, or what a ‘soft-shell reservoir’ is on page 23, for example. Some of the illustrations in these early chapters are of poor quality—Figure 1.7 is blurred and many of the photographs are of specific equipment that will quickly date. Chapter 2 is primarily an appendix consisting of a pre-bypass checklist. These reservations aside, the rest of the book is very well written and presents a well-balanced approach to many of the controversies surrounding cardiopulmonary bypass, despite some repetition on autologous priming in several of the early chapters. The chapters on anticoagulation, metabolic management, and myocardial protection in particular are excellent, although the separation of the chapter on conduct of bypass from that on weaning from bypass by two intervening chapters struck me as odd. The second half of the book covers more complex procedures, such as mechanical circulatory support, hypothermic circulatory arrest, and extracorporeal membrane oxygenation, and complications resulting from cardiac surgery, such as acute renal injury and cerebral dysfunction. These chapters are well written and many summarize quite complex fields in a very straightforward manner that is easy to understand, I particularly enjoyed the chapters on deep hypothermic circulatory arrest and cerebral morbidity. Have the editors fulfilled their objectives? This book provides a good grounding in clinical perfusion practice for trainee perfusionists, theatre and ICU nurses, operating department practitioners, and specialist trainees undergoing core and higher training in cardiac anaesthesia, although the cost may put them off. I think that experienced perfusionists and cardiac anaesthetists may be looking for more detail and more comprehensive referencing. It would be a useful addition to a departmental library, as it provides sufficient detail for trainees preparing for examinations.