Adult cardiothoracic anesthesiology (ACTA) is now firmly established as a subspecialty within anesthesiology as it has been more than a decade since the Accreditation Council for Graduate Medical Education (ACGME) began accrediting training programs. Coincidently, the past decade has seen the developing concept of anesthesiologists assuming more responsibility for perioperative care beyond the O.R. and payment models that reward overall outcome, instead of merely collecting a fee for the service provided. Training requirements for ACTA specifically require demonstration of competence in preoperative patient evaluation and optimization of clinical status prior to the procedure, interpretation of cardiovascular and pulmonary diagnostic test data, hemodynamic and respiratory monitoring, pharmacological and mechanical hemodynamic support, and perioperative critical care, including ventilator support and perioperative pain management.1
The knowledge and skills expected of a cardiothoracic anesthesiologist are broadly applicable beyond the cardiac O.R.s, where perioperative care and optimization are arguably even more important during non-cardiac...
