Understanding Acid-Base

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From The New England Journal of Medicine, October 15, 1998
For most students of medicine, acid-base homeostasis (and its disorders) remains an elusive and arcane subject. This is not surprising: the concepts underlying the clinical management of acid-base homeostasis are complex, involving chemistry as well as physiology, and textbooks on the subject often fail to communicate these concepts clearly. Understanding Acid-Base is a remarkably successful attempt to cut through this complexity and to present the subject unambiguously....

All the aspects of the book have been given meticulous attention, from the instructive approach to the structure and content of each chapter. The book is organized into five distinct sections: chemistry, physiology, pathophysiology, diagnosis, and treatment. As the author indicates in the introduction, each is self-contained so that readers can pick a section of interest to read as a "stand alone," depending on their level of knowledge of the subject. The book is so readable, however, that readers can quickly move from one section to the next to get more information.

The first section is preceded by a brief review of the fundamentals, including the definitions of "ion," "mole," and "equivalent." This chapter sets the stage: throughout the book, there is no ambiguity, and there is nothing that is not explained completely. Each section ends with a comprehensive self-assessment quiz, with answers provided, in classic textbook fashion. Although the book focuses on the information necessary to understand and manage acid-base disorders, a valuable feature is the appendix, which covers specific areas in more depth. Readers can peruse these areas or not, depending on their level of interest. The appendix is brief and readable as well....

The clarity, instructive style, and readability of Understanding Acid-Base make it one of the best in the field both for beginning students and for those who want to refresh their basic knowledge in the area....
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Critical Care Nurse
After finishing Benjamin Abelow s Understanding Acid-Base, I feel confident making two statements: I learned a remarkable amount of new information on a subject I thought I was well versed on; and this text will soon become "The Manual" of acid-base balance.

The book begins with a review of fundamentals that is both comprehensive and succinct. Section 1, Chemistry, was dry reading but absolutely essential to understanding how the author has conceptualized learning the subject matter. The text is filled with mnemonics, illustrations, and clinical notes, all ensuring that the reader understands the area discussed. Section 2, Physiology, and section 3, Pathophysiology, were a joy to read. The author has a gift of presenting complex processes with ease as clinically relevant explanations. When read in sequence each section, although designed to stand alone, guides the reader through the complicated world of acid-base balance. This book is filled with the ah-ha s we all look for when trying to teach our students or understand our patient s status. Each section concludes with a self-assessment quiz with the answers reviewing the section points. This aids in the reader s sense of mastery and knowledge acquisition.

Section 3, Pathophysiology, and 4, Diagnosis, should be required reading for every nursing student. Once again, Abelow uses clear, easy to understand concepts in describing the clinical causes of the four primary acid-base disturbances. His illustrations and mnemonics are strong enough to stay with the reader long after the section is completed. The discussion of anion gap is by far the most effective explanation I have ever read. His clear language, superb illustrations, and thoughtful style all culminate in the reader s sense of knowing.

Section 5 reviews the treatment of the disorders in a global context; therefore, if specific guidelines are necessary, additional sources will be required. The Appendix: Continuing Education provides an increased depth of coverage for those who wish to explore specific content areas.

I predict Abelow will forever be associated with acid-base, as Dubin is with EKG, or Bates with physical assessment. Understanding Acid-Base has the unique fortune of informing the generalist and enlightening the specialist. It is a "must buy" for all acute care nurse practitioners and critical care nurses. Reviewed by Linda Honan Pellico, RN, CS, MSN, CCRN, Yale University School of Nursing, New Haven, Conn. Reprinted with permission from Critical Care Nurse, vol 18, no. 3, June 1999, Aliso Viejo, CA.