Anesth Analg 2006;102:657-658
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000196877.21066.36
BOOK AND MULTIMEDIA REVIEWS
Section Editor:
Norig Ellison
Recent Advances in Anaesthesia and Intensive Care, Vol. 23
Paul S. Molinari, MD
Assistant Professor of Anesthesiology, University of Minnesota, Minneapolis, MN
Recent Advances in Anaesthesia and Intensive Care, Vol. 23. Cashman JN, Grounds RM, eds. Cambridge, UK: Cambridge University Press, 2005. ISBN 1-841101-45-1, 226 pages, $60.00.
Recent Advances in Anaesthesia and Intensive Care, Vol. 23 is not a traditional text, but more of a compendium of current topics. The chapters vary widely from highly theoretical to very clinical. This book disproves the conventional teaching that information contained in books is at least 2 years behind the current practice. Some of the best informed experts present the most recent information in their field of study.
A good example of the highly theoretical subject material is the first chapter, "Pharmacogenetics" of drugs, a new topic for most practitioners. Pharmacogenetics, which has only been addressed in medical school curriculum recently, has grown tremendously primarily because of the research on the human genome. The author takes you through the early history of genetics and ties the history together with the known variability of drug responses. The chapter is well presented and referenced and, true to the up-to-date nature of the topic, the author has also made references to Web sites with URL addresses. This is the only chapter to use Web site references and very apt considering the topic presented and the rapid growth of information in the genome project.
The following chapters are not as foreign to those of us who have trained more than 10 years ago. The chapters on opioid receptors, coagulation, myocardial protection, and heart failure are excellent reviews that bring forth the newest views on treatment modalities. Overall, these discussions are succinct, yet develop a cogent understanding of the change in practice.
For this reviewer, the chapter on blunt chest trauma was the most fascinating. The authors’ description of the functional injuries and their classification was extremely organized. The development of physical examination findings and standard x-rays lead into a most fascinating discussion of ultrasonography. With the advances of technology, the availability of ultrasound imaging is now available to all clinicians for bedside use.
The chapter on sepsis and the use of drotrecogin represents another topic that is in the forefront of medical therapies that have only been recently available. The author briefly develops the issue of sepsis and the inflammatory response. However, if one is not familiar with the interaction of activated protein C, the coagulation cascade, and tissue necrosis factor, it is difficult to follow how drotrecogin interacts. The author proceeds with a very concise description of the research and presents data and findings that have just recently been published.
The chapter on digestive tract decontamination is interesting in its discussion of practice differences. The author presents the rationale for treatment along with the statistically significant findings. After the science is well laid out, the author then tries to explain the actual practice and the professed biases. This brings the decontamination issue to the level of "prophylactic" antibiotics in the treatment of aspiration. Although not recommended, it seems most everyone does prescribe prophylactic antibiotics.
Chapter Ten covers glycemic control in the critically ill patient. This chapter does a convincing job justifying tight control of serum glucose. A good description of the data available is provided, both supportive and critical of insulin administration. One issue not addressed is a discussion of insulin resistance, an emerging problem that can be difficult to treat.
The final chapter presents management schemas for the patients with a drug abuse history. The problem with managing patients with an abuse history has been sporadically covered by other scholarly works. This chapter presents a logical therapeutic approach to management of these patients.
Overall, this book provides the reader with an eclectic selection of topics, many of which are new areas for the practicing physician. Medical students have a far better understanding of such issues as pharmacogenetics than even the senior trainees. By reading this book, attending anesthesiologists will keep their knowledge base on par with future trainees.
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