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Anesthesiologist in cardiac catheterization laboratory; the roles and goals!! A postgraduate educational review
Akshaya N Shetti1, Shivanand L Karigar2, Rachita G Mustilwar3
1Department of Anaesthesiology and Critical Care, Rural Medical College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India.
Insights
Cardiac anesthesiologists are crucial for cardiac catheterization centers (CCL) in developed nations. However, in developing countries, untrained anesthesiologists often manage CCLs, highlighting a critical need for specialized training and resources.
Area of Science:
- Anesthesiology
- Cardiology
- Interventional Cardiology
Background:
- Cardiac catheterization laboratories (CCL) in developing countries are often managed by anesthesiologists without specialized cardiac training.
- This contrasts with developed countries where cardiac anesthesiologists predominantly provide services in CCLs.
- The increasing number of CCLs outpaces the availability of trained cardiac anesthesiologists in some regions.
Purpose of the Study:
- To address the challenges faced by anesthesiologists in cardiac catheterization centers.
- To emphasize the importance of specialized training for managing complex cardiac procedures outside the operating room.
- To guide both cardiac and non-cardiac anesthesiologists in providing systematic patient care in CCL settings.
Main Methods:
- This article is a review and expert opinion piece.
- It synthesizes current practices and challenges in anesthesiology for cardiac catheterization procedures.
- It highlights the need for improved infrastructure and training within CCLs.
Main Results:
- Anesthesiologists require comprehensive knowledge and skills to manage patients in critical CCL environments.
- Inadequate training and resources can lead to increased patient morbidity and mortality.
- CCL infrastructure development often overlooks the essential needs of anesthesiologists.
Conclusions:
- Specialized training for anesthesiologists is vital for safe and effective patient care in cardiac catheterization centers.
- A systematic approach and adequate resources are necessary to improve outcomes in interventional cardiology.
- Addressing the gap in cardiac anesthesiology expertise in developing countries is crucial for patient safety.
Abstract:
It is not uncommon to see in developing and underdeveloped countries, where the anesthesiologist who is untrained in cardiac specialty takes care of cardiac catheterization centers. The service in cardiac catheterization laboratories (CCL) in developed countries and some of the developing countries is mainly provided by the cardiac anesthesiologists. The scenario is not same in some part of developing countries or in underdeveloped countries which are mainly due to increase in number of CCL (catheterization laboratory) when compared to the number of cardiac anesthesiologists working outside the operation theater. It is also important for training the postgraduate in this field as to make them capable and competitive in managing such cases during emergency situation as it may save the life of a patient. Many a times, CCL is built as per the need of cardiologist ignoring the basic needs of cardiac anesthesiologist. It is important to note that anesthesiologist should be competent enough to provide complete, integrated anesthetic care outside the operation theater with available resources. It is challenging for the anesthesiologist to provide sedation or general anesthesia in such critical area where he/she will be dealing with life-threatening situations. In the modern era, the interventional techniques are advancing and treating complex heart diseases is more often. Days are not far where the CCL procedures may reduce the requirement of major surgeries. A careful and dedicated approach by the anesthesiologist with thorough knowledge and skills decreases morbidity and mortality rate. This article helps both cardiac and noncardiac anesthesiologists to improve their knowledge and to approach the patient systematically.
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