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Manual of Perioperative Care in Adult Cardiac Surgery, 5th Edition



Manual of Perioperative Care in Adult Cardiac Surgery, 5th Edition

Robert M. Bojar

ISBN: 978-1-444-34824-8 August 2011 Wiley-Blackwell 832 Pages

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The fifth edition of Bojar's Manual of Perioperative Care in Adult Cardiac Surgery remains the gold standard for management of adult patients undergoing cardiac surgery.

The easily referenced outline format allows health practitioners of all levels to understand and apply basic concepts to patient care--perfect for cardiothoracic and general surgery residents, physician assistants, nurse practitioners, cardiologists, medical students, and critical care nurses involved in the care of both routine and complex cardiac surgery patients.

This comprehensive guide features:

  • Detailed presentation addressing all aspects of perioperative care for adult cardiac surgery patients
  • Outline format allowing quick access to information
  • Chronological approach to patient care starting with diagnostic tests then covering preoperative, intraoperative, and postoperative care issues
  • Additional chapters discuss bleeding, the respiratory, cardiac, and renal subsystems as well as aspects of care specific to recovery on the postoperative floor
  • Updated references, information on new drug indications and new evidence to support various treatment/management options.

Practical and accessible, this new edition of Manual of Perioperative Care in Adult Cardiac Surgery is the essential reference guide to cardiac surgical patient care.

Preface ix

Acknowledgments xi

1. Synopsis of Adult Cardiac Surgical Disease 1

2. Diagnostic Techniques in Cardiac Surgery 85

3. General Preoperative Considerations and Preparation of the Patient for Surgery 129

4. Cardiac Anesthesia 173

5. Cardiopulmonary Bypass  227

6. Myocardial Protection 263

7. Admission to the ICU and Monitoring Techniques 279

8. Early Postoperative Care 301

9. Mediastinal Bleeding 345

10. Respiratory Management 383

11. Cardiovascular Management 437

12. Fluid Management, Renal, Metabolic, and Endocrine Problems 581

13. Post-ICU Care and Other Complications 641

Appendices 727

Appendix 1A American College of Cardiology Classes of Recommendation and Levels of Evidence 729

Appendix 1B New York Heart Association Functional Classification 729

Appendix 2 Typical Preoperative Order Sheet 730

Appendix 3 Typical Orders for Admission to the ICU 731

Appendix 4 Typical Transfer Orders from the ICU 734

Appendix 5 Typical ICU Flowsheet 737

Appendix 6 Hyperglycemia Protocol for Cardiac Surgery Patients 738

Appendix 7 Heparinization Protocol for Cardiac Surgery Patients 739

Appendix 8 Protocol for Initiating Warfarin 740

Appendix 9 INR Reversal Protocol 741

Appendix 10 Drug, Food, and Dietary Supplement Interactions with Warfarin 742

Appendix 11 Doses of Parenteral Medications Commonly Used in the ICU and Their Modification in Renal Failure 743

Appendix 12 Doses of Nonparenteral Drugs Commonly Used

After Heart Surgery and Their Modifications in Renal Failure 747

Appendix 13 Definitions from the STS Data Specifications (Version 2.7 2011) 753

Appendix 14 Body Surface Area Nomogram 756

Appendix 15 Body Mass Index Chart 757

Appendix 16 Technique of Thoracentesis 758

Appendix 17 Technique for Tube Thoracostomy 759

Appendix 18 Technique of Insertion of Percutaneous Tracheostomy Tube 761

Index 765

“This edition, updated in light of recent technological advances, provides an up-to-date, easy-to-readreview, and contains sufficient detail to make it suitable as a single volume manual for cardiac surgical trainees or nurses.”  (Cardiology News, 2012)

"Surgeons are frequently asked to recommend a text that can be used to guide the care of their patients. This comprehensive text is the standard by which any other text should be judged. Every intensive care unit that treats adult open heart surgery patients should have several copies readily available at all times." (Critical Care Medicine, 1 October 2011)

"This fifth edition of a popular manual has been extensively revised. It is densely packed with information in its 820 ages. . . Young trainees in cardiac surgery, anaesthesia and intensive care, will find this an invaluable resource." (British Journal of Cardiology, 1 August 2011)

"This edition has been updated to incorporate current approaches to patient care." (Booknews, 1 April 2011)