The necessity of conversion from coronary care unit to the cardiovascular intensive care unit required for cardiologists

J Cardiol. 2019 Feb;73(2):120-125. doi: 10.1016/j.jjcc.2018.10.001. Epub 2018 Oct 17.

Abstract

The in-hospital mortality rate of acute myocardial infarction (AMI) has dramatically decreased due to the treatment at the coronary care unit (CCU), especially with the progress of arrhythmia therapy and reperfusion therapy. On the other hand, severe heart failure and multiple organ failure are increasing due to aging populations and multiple organ diseases. As a result, patients with AMI without complications are less likely to be admitted to the CCU, and cardiologists staying in the CCU have also decreased. The mortality rate is high when complications such as cardiogenic shock, cardiac rupture, and in-hospital cardiac arrest occur in AMI, therefore careful intensive care even in low-risk AMI is necessary. For cardiologists, mechanical ventilation, renal replacement therapy, or infection control are necessary for cardiovascular intensive care, and integrated multidisciplinary care coordinated by skilled intensive care physicians, nurses, respiratory therapists, physiotherapists, pharmacists, nutritionists, social workers, and clinical engineers is important. Therefore, for the critical care of cardiovascular diseases, it is necessary to convert from CCU to the cardiovascular intensive care unit.

Keywords: Cardiogenic shock; Cardiovascular intensive care unit; Coronary care unit; Risk score.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Cardiologists*
  • Coronary Care Units / statistics & numerical data*
  • Critical Care / methods*
  • Female
  • Heart Rupture, Post-Infarction / etiology
  • Heart Rupture, Post-Infarction / mortality
  • Hospital Mortality
  • Humans
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / mortality*
  • Patient Care Team
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / mortality