Ann Thorac Surg 1996;62:39
© 1996 The Society of Thoracic Surgeons
Review of Recent Books
Handbook of Patient Care in Cardiac Surgery
By Gus J. Vlahakes, John H. Lemmer, Jr, Douglas M. Behrendt, and W. Gerald Austen Boston, Little, Brown, 1994 302 pp, illustrated, $38.95 IBSN 0-316-08779-3
James W. Asaph, MD
See also page 31.
For any heart surgeon in training, Handbook of Patient Care in Cardiac Surgery is a valuable tool in learning how to manage patients who are undergoing heart operations, whether pediatric or adult. It is also an excellent review for the heart surgeon who has been away from a training program for several years. This, the 5th edition of a classic paperbound handbook (previously titled Patient Care in Cardiac Surgery ), expands the original publication of "the Massachusetts General Hospital way" of approaching postoperative cardiac care to reflect a broader view of contemporary cardiac surgery. The chapters have all been completely revised and a section on heart and lung transplantation has been added.
The book is well organized into eight chapters and six appendixes. Each chapter covers a single aspect of patient care in a concise but usefully detailed review of the management of specific aspects of cardiac surgery. The topics covered are: Preoperative Evaluation and Management, Operative Management, Postoperative Management, Cardiac and Pulmonary Complications, Other Organ System Complication, Late Postoperative Management, Pediatric Cardiac Surgery, and Transplantation. Included are algorithms to address specific problems, excellent tables summarizing various pharmacologic protocols, and comprehensive references on each subject. Specific operative techniques are noted only in passing.
The final 20 pages of appendixes cover bacterial endocarditis prophylaxis, drug protocols for both adult and pediatric patients, desired serum concentrations of drugs, and drug renal impairment adjustments, along with normograms to determine body surface area.
The illustrations are primarily diagrammatic but effective, and the text is clearly written and organized in a consistent and effective manner throughout the book. It correlates both surgeon and nursing perspectives, advocating the team approach to patient management. The chapter dealing with postoperative hypotension and low cardiac output conditions is particularly well done. This is a handbook that should be found in the personal library of every cardiac surgeon in training and on the ward of every cardiac surgery intensive care unit.
Portland, Oregon
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Ann. Thorac. Surg. 1996 62: 31-38.
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