Online Book Reviews
Clinical Fluid Therapy in the Perioperative Setting,
Second Edition, by Robert G. Hahn. Published by
Cambridge University Press, Cambridge, United Kingdom.
291 pages, $89.99, 2016. ISBN: 978-1-1071-1955-0
C
linical Fluid Therapy in the Perioperative Setting is a
practical hardcover handbook that is targeted toward
residents in Anesthesiology, Critical Care Medicine,
Trauma Surgery, or the surgical subspecialties. For those who
would be so inclined, it is easy to read cover to cover, but it best
serves as a straightforward reference textbook.
Clinical Fluid Therapy is organized into four sections: Sec-
tion 1 deals with the composition of various IV fluids, Section
2 focuses on the basic science behind circulatory homeostasis
and dyshomeostasis, Section 3 provides techniques for moni-
toring fluid therapy, and Section 4 discusses approaches to
fluid therapy in specific clinical subsets of patients. Within each
of these sections, individual chapters are authored by noted
experts in a broad array of specialties including anesthesiology,
nephrology, surgery, and critical care and are descriptively titled
to allow readers to easily find answers to specific clinical ques-
tions. For example, Chapter 5, “Hypertonic fluids,” starts with
a concise introduction to the preclinical rationale for the use of
hypertonic solutions and then provides a detailed critical sum-
mary of the pivotal clinical trials that have informed the use
of these therapies. In Chapter 7, “Body fluids and fluid kinet-
ics,” the reader is provided with a succinct summary describ-
ing where IV fluids redistribute and how fast they redistribute
into the various body compartments. Some of the chapters will
be a “must read” for general intensivists because they deal with
approaches to or complications of fluid therapy that are unique.
Post-Anesthesia Care: Symptoms, Diagnosis, and
Management, by James W. Heitz. Published by
Cambridge University Press, Cambridge, United Kingdom.
382 pages, $79.99. ISBN: 978-1-1076-4221-8
T
his is the first edition of Post-Anesthesia Care: Symptoms,
Diagnosis and Management edited by James W. Heitz
and published by Cambridge University Press. In addi-
tion to serving as the editor, Dr. Heitz is the author or coauthor
of a number of the chapters. The paperback book consists of
382 pages, divided into three sections and 50 succinct chap-
ters. The reference is well-written and serves to organize the
principles associated with managing the events associated with
postanesthesia, postsurgical, and postprocedural care. As the
Copyright © 2017 by the Society of Critical Care Medicine and Wolters
Kluwer Health, Inc. All Rights Reserved.
Critical Care Medicine
Copyright © 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Chapters that fit into this category include Chapters 25, “Trans-
plantations,” Chapter 30, “Uncontrolled hemorrhage,” Chapter
31, “Burns,” and Chapter 33, “Absorption of irrigating fluid.”
The only comparable textbook to Clinical Fluid Therapy in
the Perioperative Setting would be the fifth edition of Fluids and
Electrolytes in the Surgical Patient by Carlos Pestana (Lippincott
Williams & Wilkins, 1999). However, this latter textbook has
not been recently updated and is now a little dated. In deciding
whether to purchase Clinical Fluid Therapy in the Perioperative
Setting, it is important to remember that by design, reference
textbooks must include information that will appeal to a broad
range of learners from novices to experts. So, new trainees may
appreciate the cookbook “how I do it” recommendations that
offer recipes for managing fluids. However, experienced prac-
titioners may find a few of these chapters to be a little over-
simplified. Similarly, some readers will value the repetition of
certain concepts, such as goal-directed therapy, across chap-
ters, while others will prefer to skip past these redundancies.
All in all, I feel that the second edition of Clinical Fluid
Therapy in the Perioperative Setting is a valuable contemporary
reference that deserves a place in the teaching library of most
acute care training programs.
Bennett P. deBoisblanc, MD, FACP, FCCP, FCCM
Section of Pulmonary/Critical Care Medicine &
Allergy/Immunology
Louisiana State University Health Sciences Center
New Orleans, LA; and
University Medical Center
New Orleans, LA
DOI: 10.1097/CCM.0000000000002658
editor surmises in the introduction, the postanesthesia care
unit (PACU) is a unique interdisciplinary setting where the
clinical presentation of a problem may be obscured, and timely
and appropriate interventions impact the outcome. In addi-
tion, when hospital beds are filled to capacity, the PACU may
serve as the overflow site for the ICUs. This reference is use-
ful for clinicians who routinely care for patients in the periop-
erative period and may be an effective resource for consultant
clinicians who may not primarily manage patients in the peri-
operative setting but are often called upon the assess a patient
after a procedure.
The reference is easy to follow and presents clinical informa-
tion at a suitable level of complexity appropriate to the prac-
ticing clinician. Each chapter starts with three to four bullets
of general principles, followed by a succinct overview of the
key concepts, then followed by well-organized, evidence-based
physiology, pathophysiology, pharmacology, historical con-
text where applicable, physical findings, clinical presentation
www.ccmjournal.org e1207
Online Book Reviews
including variations in presentation affected by intraoperative
events, mechanisms, differential diagnoses, and management
principles. Most chapters include decision trees, algorithms,
mnemonics, and tables to guide evaluation and management.
Table 2.1, comparing practice guidelines for recovery care
and discharge from the European Society of Anesthesiology,
the American Society of Anesthesiologists, and The American
Society of PeriAnesthesia Nurses, is quite good. There are two
chapters that review findings that may uniquely present during
recovery from a procedure, for example, Chapter 29, “Crying”,
and Chapter 37, “Abnormal Urine Color”. The author takes a
seemingly ordinary finding and emphasizes the application
of diagnostic skill in assessing when a finding is benign or
critical and requiring further rapid intervention. Also notable,
Chapter 14, entitled, “Fever, Hyperpyrexia, and Hyperthermia”,
e1208 www.ccmjournal.org
Copyright © 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
highlights the other likely causes of postoperative fever, for
example, not malignant hyperthermia. This section succinctly
addresses early postoperative fever, dividing the causes and
workup into noninfectious, infectious, drug-associated, endo-
crine, and other iatrogenic causes.
This reference is a very useful aid that can improve the cli-
nician’s diagnostic specificity pertaining to a number of signs
and symptoms that present in the postoperative period.
Mary J. Njoku, MD
Department of Anesthesiology
University of Maryland School of Medicine
Baltimore, MD
DOI: 10.1097/CCM.0000000000002679
November 2017 • Volume 45 • Number 11