Extracorporeal Circulation in Theory and Practice

By Luc Puis

It takes work to write a book.

It helps to have 62 experts from multiple countries and various disciplines contributing to it, but it is still not a light task.

It also helps that the topic of your book is only one thing, but when your case is so multi-faceted and interdisciplinary that you could write a whole bunch of books on the different features, it becomes rigid again.

It’s also not easy to review a book… (especially when you know many of the authors.) 😉

When I first heard about this book, I was very excited because it was around the same time that the European Board for Cardiovascular Perfusion (EBCP) decided that they would use this book as the single source of literature for their certification examination (EBCP, 2021). That must be THE definitive book on cardiopulmonary bypass (CPB) and extracorporeal circulation (ECC)! The EBCP offers it for a reduced price for their members and anyone participating in the EBCP Certification Exam. While shipping it outside of Europe might become costly, the book is available to buy as a PDF on the Pabst Publishing website. 

What is in it?

The book is divided into 60 chapters, spread over 18 sections. (See the Table of Contents). There is an enormous amount of information available, although it is almost impossible to complete. The list of authors is an impressive collection of names with many publications and lots of experience. The texts are clear, and the chapters are mostly concise and to the point, without too much dwelling on details.

The editors have not made it easy on themselves by choosing to print the pictures and illustrations in a blue hue, which only sometimes adds to clarity. Some illustrations are just simple drawings (the pumps), and I’m sure there are better illustrations or pictures available. On the other hand, the diagrams on filtration and cannula design are comprehensive and give an excellent overview. A pity that there is no description of the different cannulas illustrated.

What I really like about the book is that it is easy to read, the chapters are not too long, and mostly complete. Of course, there is always room for improvement, and sometimes I had to raise an eyebrow…

What is NOT in it?

While it is almost impossible to cover every aspect of extracorporeal circulation and put it in a book you don’t want to carry around in a wheelbarrow, some elements of ECC should have been there, in my humble opinion.

There needs to be a section on training and education. That is understandable, and some tough choices must be made when picking topics. But a book on cardiopulmonary bypass that does not cover goal-directed perfusion, a concept that has been a steady discussion topic during meetings and conferences over the past 10 to 15 years, is almost unacceptable. The whole chapter on the effects of CPB on the kidney does not contain any reference to articles related to goal-directed perfusion, which is the only actual perfusionist intervention recommended to mitigate the impact of CPB on kidney function.

The chapter on Practical Management of Extracorporeal Circulation consists of only six pages, which might be enough because it contains all management elements, and many aspects of managing ECC are covered in the other chapters. But, in contrast, there are 15 pages dedicated to Pacemakers and Implantable Defibrillators. Not that we do not need to know how these work, but it seems overkill. Also, a chapter of seven pages, with an additional 163 (!) references on Stem Cell Therapy, could have been replaced by more meaningful topics that are not covered in the book.

Lastly, I am expressing my concern about the last chapter in the book, Controlled Automated Reperfusion of the Whole Body. While I do not wish to discuss the presented technique, outcomes, or the products used, I find it concerning that this product is highlighted in a separate chapter and that the chapter is written by people who play a role in the management of the company represented. At least a full disclosure of a Conflict of Interest is warranted. It would be as if the chapter on Autotransfusion would present only one of the cell savers on the market. 

Conclusion

This a very well-designed book, with much detailed but to-the-point information, that can be a reference for the many disciplines involved in the care of patients undergoing extracorporeal circulation.

However, I would have found it even better if certain chapters were left out and replaced with other, more relevant subjects.

I would also appreciate it if all contributors had disclosed their conflicts of interest, which would add to the book’s credibility.

Sources

Link to the Publisher’s Website

Link to Table of Contents

Link to Extract

EBCP, No Author, (2021) EBCP Exam book https://www.ebcp.eu/ebcp-exam-book.html

(accessed 11/10/2022)