The Oxford Textbook of Cardiothoracic Anaesthesia

Abstract

The Oxford Textbook of Cardiothoracic Anaesthesia is the first edition of a multi-authored international collaboration that includes authors predominantly from the United Kingdom, Italy, and Australia. Overall, the book covers management, pathophysiology, and diagnosis of multiple cardiac and thoracic diseases, as well as other pertinent topics related to cardiothoracic anesthesia, such as pain management and training program curricula. The preface summarizes the objective of the book: “providing the theoretical knowledge required to inform optimal clinical practice…using an evidence-based approach.” It is an ambitious goal, especially because there are over 40 different chapter topics covered within approximately 500 pages. The book’s table of contents is consistent with topics found in other major cardiac anesthesia textbooks. Notable in content are the chapters on “Ultrasound Imaging in Critical Care,” “Anaesthesia for Interventional Bronchoscopy,” and “Designing State-of-the-Art Cardiothoracic Surgical Suites.” The 4-page-long abbreviation section that follows the table of contents provides an interesting indication of some of the different societies, their scoring systems, and terminology that exist overseas compared with those of the United States. At an average of 10 pages per chapter, for a total of 475 pages, the book is condensed and the language is generally straightforward. In keeping with today’s technological demands, an interesting feature of the textbook is the fact that it is available to be read online. The entire content of this book, including its images, is available on the Oxford Medicine Online Web site. The chapters can be downloaded into a portable PDF format that allows the reader to share by e-mail, markup electronically, print, or access via the Internet. When viewing the text online, readers can perform a search for specific content. Images found in the book can be easily downloaded onto a PowerPoint presentation or as full-size figures. The first 10 chapters of the book cover anatomy and physiology related to cardiothoracic anesthesia. The substance of these chapters is comparable with information found in most major general anesthesia textbooks. The organization of topics, however, is somewhat unusual. For example, the chapter on hypothermia and circulatory arrest is followed by the chapter on myocardial protection during cardiac surgery. There is a single chapter on pediatric cardiac and thoracic anesthesia that sits between anesthesia for off-pump coronary bypass grafting and anesthesia for thoracic aortic surgery. In addition, the book lacks any discussion on emerging technologies and percutaneous cardiac procedures, such as transaortic valve replacement, which may arguably be considered a necessary topic for future cardiac textbooks. There is a wide variation in the quality of the content of the chapters, and that is likely a reflection of the large number of contributing authors and the variety of countries involved. The chapter on ultrasound imaging in critical care is nicely laid out, with a number of easy-to-read tables. It summarizes ultrasonography well and provides a nice amount of 2D images to highlight teaching points. The anesthesia for thoracic surgery chapter is also well written, organized, and provides multiple tables and images that are relevant and helpful to clinicians who must place double lumen tubes. These chapters would benefit readers at all levels. Other chapters, such as that on extracorporeal membrane oxygenation and mechanical support of the circulation, are too brief, given the complexity and frequency with which those procedures occur. Overall, The Oxford Textbook of Cardiothoracic Anaesthesia is a compact and easy reference for anesthesia providers in training. It provides a summary of many pertinent and contemporary topics related to cardiothoracic surgery rather than an in-depth review of the basic sciences and cardiothoracic literature. The online access it provides enhances the experience significantly by creating a convenient and valuable reference source for the mobile trainee. Huong Le, MD Gregory M. Janelle, MD Department of Anesthesiology University of Florida Gainesville, Florida [email protected]