Reviews of Educational Material  |   July 2003
Clinical Monitoring: Practical Applications for Anesthesia and Critical Care.
Author Notes
  • Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Article Information
Reviews of Educational Material
Reviews of Educational Material   |   July 2003
Clinical Monitoring: Practical Applications for Anesthesia and Critical Care.
Anesthesiology 7 2003, Vol.99, 243. doi:
Anesthesiology 7 2003, Vol.99, 243. doi:
Clinical Monitoring: Practical Applications for Anesthesia and Critical Care. By Carol L. Lake, Roberta L. Hines, Casey D. Blitt. W. B. Saunders, Philadelphia, Pennsylvania, 2001. ISBN: 0721686982. Pages: 600. Price: $100.
When I finished this book I could not help but think to paraphrase two common expressions. “We are what we monitor  [not eat].” This book teaches us (like the army) “to be all that we can be.” Every chapter in this book is worth reading and periodically rereading. Each covers the basics well and suggests ways we can extract more useful information from our monitors. The chapters entitled “Evoked Potentials” and “Monitoring the Function of the Respiratory System” stand out because they clarified concepts frequently confusing to me. Those entitled “Monitoring the Neuromuscular Junction” and “Monitoring Coagulation and Hemostasis” stand out because they took basic concepts that I thought I knew reasonably well, provided more up-to-date basic science background, and expanded my understanding of the applications. But these are personal responses. Others would single out different chapters for special mention. The chapters entitled “Pulmonary Artery Catheterization,”“Perioperative Echocardiography,” and “Maternal and Fetal Monitoring in Obstetrics” could stand alone as must-read monographs for weekend continuing medical education courses focusing on these areas. I also liked how thoughtful the editors were in finding authors for chapters related to monitoring in non–operating room (magnetic resonance imaging and lithotripsy suites), office-based, and pain clinic settings and point-of-care monitoring. The editors also took a chance with chapters entitled “Arterial Blood Gas Analysis” and “Biochemical and Metabolic Indicators,” because most of us tend to think in terms of mechanical responses and digital readouts rather than laboratory values when we think monitoring. These are excellent inclusions.
However, I must blemish this rave review with a few criticisms. The introductory section just does not work. Most of us will select this book as a reference based on its title rather than as a source to answer questions about “Information Systems” or “Patient Simulators.” Nor will most of us read “Principles of Pressure Monitoring” before going to chapters on the application of pressure monitoring. I would eliminate these chapters in future editions, not because they are poorly written—in fact, they are excellent—but because too few people will read them in this setting. I also disliked showing pictures of often-used commercial devices, such as Dinamaps, MiniStims, esophageal stethoscopes, and so forth. Finally, as with any multi-authored textbook, there were some overlaps that the editors could have avoided, e.g.  , near-infrared spectroscopy in chapters 11 and 18, capnography in chapters 16 and 17, and pulse oximetry in chapters 18 and 23.
What is missing from this text? I would have welcomed whole chapters focused solely on venous air embolism, awareness or depth of anesthesia monitoring, and electrocardiographic monitoring of pacemakers, rather than the few pages given to these subjects. I also would have preferred a separate chapter devoted to capnography rather than have it included as parts of “Monitoring the Function of the Respiratory System” and “Monitoring the Anesthesia Machine and Respiratory Gases.” And, if the editors really wanted to take a chance, a chapter on the potential effect of phenotyping in preoperative assessment centers on future anesthetic monitoring and management could be very thought provoking.
In summary, I recommend that you-all (yes, I speak as a Southerner) either get this book for your personal use or make sure it is readily accessible in your operating room suite. It should become so well worn that you will feel compelled to purchase the next edition, and I hope there is one!