A comprehensive understanding of the pathophysiology of coexisting diseases is essential for the perioperative management of patients undergoing surgery and anesthesia. The Anesthesia and Co-Existing Disease text is in its fifth edition and provides the practitioner with a good reference source regarding the pathology of common and uncommon disease states and their relevance to the anesthesiologist.
The new edition of this multi-authored text was edited by Drs. Hines and Marschall. It retains the purpose of the original publication by Dr. Stoelting, while also reflecting the advancements in medical knowledge of these subjects since the last edition of the book was published in 2002. The contributions of multiple experts enrich the substance of the text.
The uniform structure of the chapters has aided the editors in achieving consistency in the writing style. The updated edition also reflects the advances in medical knowledge and contemporary management principles.
Each chapter commences with bullet-format outline, focusing the attention of the reader on the topics that are addressed, and concludes with highlighted key points, emphasizing the important educational points. The addition of color highlighting contributes to the functionality of the text as a source for review of relevant information. Abundant, well-designed illustrations, figures, graphs, and tables supplement the text and enhance the didactic value of the book.
The chapters of the book reflect the organ system approach to the organization of the disease entities. Although common disorders have a more prominent place in the text and are presented in greater detail, the uncommon conditions are also discussed and important features are emphasized. The organization of the chapter content in the new edition has resulted in relocation of some topics to a different chapter reflecting the current understanding of the pathophysiology and management of these disease states. Some level of detail has been omitted in the discussion on bacterial endocarditis and prophylaxis recommendations, neurologic syndromes, anesthetic considerations in sleep apnea, and understanding of the strong ion difference in acid-base disorders. In addition, there are fewer references in this edition.
The leading chapter of the book is dedicated to ischemic heart disease, underscoring the significance of this entity to the practice of anesthesia. The comprehensive discussions of the pathophysiology of this disease, the risk stratification approach, and perioperative care issues present an admirable synthesis of the contemporary principles of management of ischemic heart disease. The chapter on systemic and pulmonary hypertension contains an excellent overview of the hypertension syndromes in both circulatory beds and highlights the effect of pulmonary hypertension on the administration of anesthesia. The vascular disease chapter incorporates diseases affecting the blood vessels, as well as thromboembolic phenomena. The chapter on heart failure contains an in-depth discussion of the pathophysiology of the types of heart failure and cardiomyopathy and their management in the perioperative period. A consolidated, comprehensive chapter on respiratory diseases includes discussions on the pathology and anesthetic implications of upper respiratory tract infection, obstructive and restrictive lung diseases, pulmonary embolism, and lung transplantation. The discussion on acute respiratory failure provides an excellent review of this entity and highlights the contemporary management principles of the disorder. However, the rationale for placing that discussion under the topic of diagnostic procedures rather than as a stand-alone topic is uncertain.
The disorders of the nervous system are organized into 3 subchapters, including diseases of the brain, the spinal cord, and the peripheral and the autonomic nervous system, reflecting the link between anatomic and functional correlation and clinical impact.
The discussions on obesity and other nutritional disorders contain an abundance of tables and diagrams that provide an excellent overview and highlight various issues, including obesity-related cardiomyopathy, medication dosing in obesity, inborn errors of metabolism, and cardiopulmonary changes in obesity and pregnancy.
The final chapters are dedicated to special patient populations such as obstetric, pediatric, and geriatric patients and emphasize the particular challenges that these patient populations present in the perioperative period.
The printed text is accompanied by an online feature that provides easy access to the book from any electronic portal and the ability to rapidly locate key information. The references are linked to their abstracts on MEDLINE (Medical Literature Analysis and Retrieval System Online), facilitating the acquisition of a deeper understanding on the topics of interest.
Anesthesia and Co-Existing Diseases is a unique and valuable reference text that provides anesthesia practitioners with essential expertise on the pathology of coexisting diseases and their implications for the perioperative management of surgical patients. Clinicians at all levels of their professional development, from students and residents to experienced anesthesia providers, will find this book a valuable addition to their anesthesia library.
John E. Ellis, MD
Department of Anesthesiology and Critical Care
University of Pennsylvania
Zdravka Zafirova, MD
Department of Anesthesia and Critical Care
University of Chicago