Cardiothoracic anesthesiology
This also includes management of the cardiopulmonary bypass (heart-lung) machine, which most cardiac procedures require intraoperatively while the heart undergoes surgical correction.
The arenas of research can be as diverse as neuroprotection,[3] myocardial protection,[4] blood conservation strategies,[5] and port access surgery.
Massachusetts General Hospital Department of Anesthesia, Critical Care and Pain Medicine - Fellowships Many fellowships also offer opportunity to become familiar with anesthetic techniques for pediatric cardiac surgery and minimally invasive cardiac surgery, however no formal case numbers for ACGME accreditation are required.
Fellows are trained to achieve expertise in the advanced monitoring techniques including invasive blood pressure, arterial blood gas analysis, cardiac output monitoring, jugular venous oxygen saturation, cerebral oximetry, Bispectral Index (BIS),[9] Transcranial doppler (TCD),[10] and Near infrared spectroscopy (NIRS).
It provides the detailed information about the structure and function of the heart/great vessels in real time, allowing the cardiothoracic anesthesiologist to precisely manage patient physiology while providing updates and direction to members of the surgical team throughout the pre, intra, and post operative time frame of patient care.
[14] After successful completion of the fellowship with subspecialty training in TEE, cardiothoracic anesthesiology fellows may sit for examination leading to board certification in echocardiography.
Cardiopulmonary bypass (CPB) is a technique in which heart-lung machine temporarily takes over the function of the heart and lungs during surgery.
Subsequently, it is pumped back into the arterial (oxygenated) circulation, thereby bypassing the heart and lungs and maintaining the perfusion of the vital organs.
The surgeon places a cannula in the right atrium, vena cava, or femoral vein to withdraw blood from the venous circulation.
The communication, while a team effort, is led and directed by the cardiothoracic anesthesiologist, as the surgeon is focused on acquiring and maintaining adequate exposure.
As such, this responsibility demands that the cardiothoracic anesthesiologist have a thorough knowledge of the advanced physiology, principles, practical application and management of CPB.
In other words, the heart and lung are prepared to receive, oxygenate, and pump the blood which had immediately previous been done by the CPB machine.
