In current cardiac surgery practice, most operative procedures are performed on cardiopulmonary bypass (CPB). Additionally, even those surgical procedures planned as ´off-pump´ will at times utilize CPB as a backup if needed. The processes of initiating (´going on´) CPB, maintaining adequate perfusion and oxygenation during CPB (´on pump´), and terminating (´coming off´) CPB involve intricate balances between the cardiac surgical, perfusion, and anesthesia teams. Each of these stages presents the potential for catastrophe if not appropriately controlled and clear communication is not part of routine practice. While some may view the anesthetist´s role as extraneous while on CPB, Steven Bartels and Kathirvel Subramaniam (Pittsburgh/USA) focus on the anesthetist´s role and problems from the anesthetist´s perspective and within their realm regarding patients on CPB. The detailed review appeared in the new textbook "Extracorporeal Circulation in Theory and Practice" (edited by Rudolf Tschaut et al.)....