Cardiology: intensive care reduces deaths but it is time to network them
Need to move patients according to the level of criticality and the need for organ support, but also ensure training and information transfer
by Massimo Grimaldi*
International literature shows that critically ill cardiac patients, such as those with cardiogenic shock, have a better prognosis and mortality is significantly reduced when admitted to a high-volume cardiology intensive care unit (CICU), placed in the care of cardiologists working as a team with other specialists.
The functional reorganisation of the NICUs is an unavoidable goal for Italian cardiology; it represents the starting point for rethinking and redesigning cardiology in our country. The National Conference of the NICU Club constitutes an unavoidable opportunity for comparison, discussion and in-depth analysis aimed at innovation in cardiovascular medicine in the emergency-urgency sector. In line with what has been underlined in the ANMCO Position Paper on Cardiological Intensive Care, the NICU-ANMCO Club confirms also for this year its commitment to strengthen the network collaboration among specialists in order to raise and make as homogeneous as possible the quality of care of critical patients on the national territory.
Good Clinical Practices
In this regard, ANMCO, as leader of more than 40 scientific societies and at the request of the Istituto Superiore di Sanità, has just concluded work on Good Clinical Practices to be adopted in patients with acute coronary syndrome. In its virtuous relationship with the Institutions, ANMCO actively collaborates on various technical tables also with the Ministry and Agenas. The ANMCO suggests three levels of NICUs with different complexities according to the characteristics of the hospital in which they are located and linked together in a regional network of NICUs so as to be able to guarantee all the complexities of care the patient needs regardless of the hospital of first admission. The proposed model for the reorganisation of the NICUs is centred on the NICU NETWORK, which provides not only for the movement of patients according to the level of criticality and the need for organ support, but also for a continuous flow of information and training between critical care professionals. The network of NICUs should provide for standardised data collection systems, by means of electronic records or permanent registers capable of extrapolating/extracting the necessary data for self-assessment and clinical research purposes. Complete sharing of diagnostic and therapeutic protocols within the network is essential so that the NICUs work as a single heart team.
Vocational Training
This and much more was discussed at the 5th National Conference of the ANMCO NICU Club, a conference that over the years has become one of the most eagerly awaited events on the cardiology scene in Italia. An appointment of high scientific and educational relevance, which offers an opportunity for cultural growth for all professionals in the critical area and is part of a broader strategic project of the ANMCO NICU Club aimed at promoting the progressive development of the clinical and care skills of doctors working in the NICUs, i.e. in the Cardiology Intensive Care Units of the National Health Service.
* ANMCO President and Director of Cardiology at the F. Miulli Hospital in Acquaviva delle Fonti (BA)
