As Vice Chair and Chair of the ASA Committee on Critical Care Medicine, we recognize the importance of new developments in this field and their propagation to the wider anesthesiology community.

While writing this piece, where we proudly introduce our committee's contributions to this special issue on critical care medicine, we would like to take a minute to reflect on the history of the specialty and predict the future as best as we can. At the society's 2023 Critical Care Congress in San Francisco, California, Hannah Wunsch, MD, MSc, delivered a plenary titled “From Polio to Present: How Epidemics have Shaped Critical Care.” During her captivating talk, she narrated the true story of the polio epidemic in 1952 and how tracheostomies, iron lungs (modern day ventilators), and very rudimentary intensive care units first started in one overwhelmed hospital in Copenhagen, Denmark. Bjørn Ibsen, a Danish anesthesiologist, was the first to come up with a treatment plan that included a tracheostomy and positive pressure manual ventilation with an ambu bag. These innovations saved the lives of many polio patients dying of respiratory failure then, and continued to do so as we faced COVID-19. Today, we live with these inspiring stories and hope that the future of the specialty of critical care anesthesiology and the community of resident doctors and fellows who aspire to be intensivists can further Ibsen's legacy.

The Committee on Critical Care Medicine has grown exponentially under past leadership, and new subcommittees have emerged. These members infuse fresh energy and expertise into an already diverse, vibrant, and extremely talented group of clinicians practicing at the forefront of health care. The articles written by the committee provide a wide scope of patient-centered topics that are essential in the care of the critically ill.

In the following pages, Michael Banks, MD, and colleagues discuss, in a question-and-answer format, the importance of maintaining nutrition-based physiological goals and requirements of ICU patients. They look to answer several important questions; for example, should patients with a secure airway be fasted prior to a surgical procedure, and can we provide enteral nutrition to a patient on vasopressors?

Megan Hicks, MD, and colleagues eloquently describe the historical background and development of end-of-life care, required discussions to determine goals, patients' wishes and preferences, and the role of the anesthesiologist in the perioperative period.

The critical care anesthesiologist is fast moving into roles outside of the ICU, where they demonstrate essential leadership skills necessary in the multidisciplinary care of patients as well as management of rapid response and perioperative teams. Margo Hoyler, MD, and colleagues provide perspectives on these nontraditional, non-ICU roles that will define the future of our specialty.

Jovana Rutherford, et al. explain the importance of recognizing and managing post-ICU syndrome and its impact on the lives of patients and caregivers.

Graham Trevor Lubinsky, MD, FASA, and coauthors explore the phenomenon of the “physiologically difficult airway” in a concise, informative manner, with appropriate guidance and management considerations.

One of our favorite pieces in this series is from Tyler Poi, MD, and colleagues, who delve into the challenging and complex issues involved in the care of patients requiring mechanical circulatory support, especially by noncardiac anesthesiology colleagues. They also provide a comprehensive overview and a helpful troubleshooting guide.

In addition to these articles, our enthusiastic members were able to contribute further with online articles in two more areas. Shaun R. Yockelson, MD, and coauthors wrote an insightful piece on work-life balance and its importance when considering critical care medicine as a career, especially for trainees. And Santhalakshmi Angappan, MD, and colleagues extol the rapid advances and virtues of point-of-care ultrasound (POCUS) in the care of critically ill patients and provide some excellent examples, with images to support the text.

Within this broad range of articles, our members have covered many of the pertinent areas of practice that are novel as well those that are rapidly evolving in the field. We hope you enjoy reading these as much as we have enjoyed exploring and discussing these contributions with our members. We are proud of our legacy and history, from the times of the polio epidemic to today, and we will use that inspiration to define our bright future!

Disclosure: Dr. Khanna is a grant recipient of Edwards Lifesciences, Potrero Medical, and Trevena Pharma, and a consultant for Caretaker Medical, Edwards Lifesciences, Fifth Eye Inc., General Electric, Hill Rom, La Jolla Pharmaceutical Company, Medtronic USA, Inc., Pharmazz, Inc., Philips Electronics North America Corporation, and Potrero Medical.

Shahla Siddiqui, MD, MS, FCCM, Vice Chair, ASA Committee on Critical Care Medicine, Assistant Professor, and Attending Physician, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Shahla Siddiqui, MD, MS, FCCM, Vice Chair, ASA Committee on Critical Care Medicine, Assistant Professor, and Attending Physician, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

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Ashish K. Khanna, MD, MS, FCCP, FCCM, FASA, Chair, ASA Committee on Critical Care Medicine, Associate Professor, Vice Chair of Research, and Director, Perioperative Outcomes and Informatics Collaborative, Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.

Ashish K. Khanna, MD, MS, FCCP, FCCM, FASA, Chair, ASA Committee on Critical Care Medicine, Associate Professor, Vice Chair of Research, and Director, Perioperative Outcomes and Informatics Collaborative, Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.

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