European Heart Journal Advance Access originally published online on March 21, 2005
European Heart Journal 2005 26(16):1676-1682; doi:10.1093/eurheartj/ehi202
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Recommendations for the structure, organization, and operation of intensive cardiac care units
1Poria Medical Center, M.P. Lower Galilee, Tiberias, Israel
2Hopital Europeen Georges Pompidou, Paris, France
3Evangelismos General Hospital, Athens, Greece
4Cardiovascular Institute, University of Barcelona, Spain
5Universitat Klinikum, Aachen, Germany
6Sheba Medical Center, Ramat Gan, Israel
7Ukrainian Institute of Cardiology, Kiev, Ukraine
8Aarhus University Hospital, Aarhus, Denmark
9San Fillippo Neri Hospital, Rome, Italy
10Uppsala Cardiothoracic Center, Uppsala, Sweden
11P. Stradins Clinical University Hospital, Riga, Latvia
Received 15 September 2004; revised 1 February 2005; accepted 10 February 2005; online publish-ahead-of-print 21 March 2005.
* Corresponding author. Tel: +972 4 6652648; fax: +972 4 6652678. E-mail address: yhasin{at}poria.health.gov.il
Abstract
Two major changes in patient characteristics and management occurred recently that demand distinctive alterations in the function of the intensive cardiac care unit (ICCU). These changes include the introduction of an early invasive strategy for the treatment of acute coronary syndromes, enabling early recuperation and shorter need for intensive care on the one hand, while the number of older and sicker patients requiring prolonged and more complex intensive care is steadily increasing. A task force of the European Society of Cardiology Working Group on Acute Cardiac Care was set to give a modern updated comprehensive recommendations concerning the structure, organization, and function of the modern ICCUs and intermediate cardiac units. These include the statement that specially trained cardiologists and cardiac nurses who can manage patients with acute cardiac conditions should staff the ICCUs. The optimum number of physicians, nurses, and other personal working in the unit is included. The document indicates the desired architecture and structure of the units and the intermediate cardiac unit and their relations to the other facilities in the hospital. Specific recommendations are also included for the minimal number of beds, monitoring system, respirators, pacemaker/defibrillators, and necessary additional equipment. The desired function is discussed, namely, the patients to be admitted, the length of stay, and the relocation policy. A uniformed electronic chart for ICCUs is advised, anticipating a common European database.
Key Words: Intensive care unit • Acute cardiac care • Functional recommendations • Medical equipment
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