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European Heart Journal Advance Access published online on March 21, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi202
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved

ESC Report

Recommendations for the structure, organization, and operation of intensive cardiac care units

Yonathan Hasin 1*, Nicolas Danchin 2, Gerasimos S. Filippatos 3, Magda Heras 4, Uwe Janssens 5, Jonathan Leor 6, Menachem Nahir 1, Alexander Parkhomenko 7, Kristian Thygesen 8, Marco Tubaro 9, Lars C. Wallentin 10, and Ilia Zakke 11

1 Poria Medical Center, M.P. Lower Galilee, Tiberias, Israel
2 Hopital Europeen Georges Pompidou, Paris, France
3 Evangelismos General Hospital, Athens, Greece
4 Cardiovascular Institute, University of Barcelona, Spain
5 Universitat Klinikum, Aachen, Germany
6 Sheba Medical Center, Ramat Gan, Israel
7 Ukrainian Institute of Cardiology, Kiev, Ukraine
8 Aarhus University Hospital, Aarhus, Denmark
9 San Fillippo Neri Hospital, Rome, Italy
10 Uppsala Cardiothoracic Center, Uppsala, Sweden
11 P. Stradins Clinical University Hospital, Riga, Latvia

* To whom correspondence should be addressed.
Yonathan Hasin, E-mail: 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.

Keywords: Intensive care unit; Acute cardiac care; Functional recommendations; Medical equipment.
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