What will you experience when you enter the cardiac intensive care unit?
2024-09-27
Intensive Care Unit, abbreviated as ICU. Patients usually treated in the ICU are at a higher risk and require 24-hour monitoring of their vital signs. The ICU for coronary heart disease is the coronary heart disease intensive care unit, abbreviated as CCU. CCU aims to treat patients with severe or acute coronary syndrome. In hospitals with strong cardiac surgery capabilities, the ICU that only admits coronary heart disease patients for internal medicine treatment is usually referred to as CCU, while the ICU that admits postoperative patients is called the cardiac surgery intensive care unit, abbreviated as CSICU or SICU, collectively referred to as ICU in this article. The ICU is equipped with specialized equipment for the treatment and monitoring of heart disease, as well as medical personnel who have received rigorous training in cardiac monitoring. Patients in the ICU do not simply suffer from heart disease. In many hospitals, more and more critically ill patients are entering the ICU for treatment. In addition to cardiovascular disease, these patients also have other chronic health problems that need to be managed, including sepsis, acute kidney injury, and acute respiratory failure. Which patients must be treated in the ICU? Some patients require round the clock monitoring and specialized cardiovascular treatment. They are usually admitted to the ICU due to severe, acute, and/or unstable heart disease. The most common of these are acute heart attacks or other forms of acute coronary syndrome. People with these diseases are prone to rapid and unexpected changes in their condition, often requiring uninterrupted treatment such as targeted temperature management (inducing hypothermia). Other patients who may need to stay in the ICU include: patients after cardiac surgery; Have decompensated heart failure, especially if their condition is particularly severe or unstable or requires the use of mechanical circulatory assistance devices; Close monitoring is required after severe heart failure, even if they have stabilized and are waiting for a heart transplant; Individuals with acute coronary syndrome, unstable angina, or potentially life-threatening arrhythmias. According to the "China Cardiovascular Health and Disease Report 2022" recently released by the National Center for Cardiovascular Disease, the current number of cardiovascular disease patients in China is 330 million, including 13 million stroke patients, 11.39 million coronary heart disease patients, and 245 million hypertension patients. According to a survey by the Extracorporeal Circulation Branch of the Chinese Society of Biomedical Engineering, there are over 340000 routine cardiac surgeries performed annually in China. Therefore, in most tertiary hospitals, ICU is often a busy place. What happens in the ICU? The ICU is equipped with specialized personnel and equipment to treat and manage unique issues of heart disease patients, especially when continuous monitoring is required. Nurses, technicians, and doctors who have received specialized training can provide treatment to patients 24 hours a day, and their ratio of medical staff to patients is much higher than that of ordinary wards. These critically ill patients can receive greater attention from medical staff. However, as doctors often tell patients' families, 'no news is good news', and this greater attention also means greater risks. All ICU patients require 24-hour electrocardiogram monitoring to record and analyze every heartbeat, blood pressure, blood oxygen saturation, etc. If severe arrhythmia or other abnormalities occur, an alarm will be issued to alert medical staff. Some patients may also temporarily place catheters in the arteries to continuously monitor their blood pressure, or place catheters in the pulmonary arteries to monitor blood pressure in locations such as the pulmonary arteries, in order for medical staff to better assess changes in their condition. People with severe heart failure may receive intra aortic balloon counterpulsation (IABP), extracorporeal membrane oxygenation (ECMO), or left ventricular assist devices (LVAD) to help their heart pump blood. Whether used or not, patients are equipped with ventilators; Generally speaking, patients who undergo cardiac surgery typically use a ventilator. ICU personnel often need to examine patients, so ICU is equipped with such testing equipment, including blood testing devices, electrocardiograms, echocardiograms, chest X-rays, and so on. The configuration of ICU is usually different from typical hospital wards. Most of them have a central nursing station, surrounded by 8 to 12 single or easily separated beds, each room has large glass windows, so patients can be seen unobstructed from the nursing station. The nursing station itself will be equipped with monitoring screens that display the vital signs of each patient. If any emergency situation occurs, well-trained medical personnel will immediately detect and respond. Generally speaking, many patients in the ICU are bedridden, but for those who can (and may benefit from) getting up at the designated time every day, comfortable seats can be used. Visitors are different from regular wards, ICU does not allow accompaniment, but visitors are allowed to visit patients, usually only for immediate family members. Visiting time is limited to two to three short periods per day (usually 30 minutes). Family visits can give patients great courage to cooperate with medical treatment and rehabilitation exercises. Visitors should be aware that they are prohibited from bringing out food and other items, such as flowers, as the diet of patients in the ICU often needs to be monitored, and flowers may bring bacteria that can cause infection into the ICU or cause serious allergies and danger to patients. Upon admission to the ICU, you may see your loved ones connected to numerous pipelines, including endotracheal intubation. This scene may be unsettling, but do not panic: it is to ensure that they are closely monitored and receive necessary treatment. The average ICU stay for patients undergoing cardiac surgery after being transferred out of the ICU is one to six days. After meeting the transfer criteria, most patients are transferred to the intensive care unit within the cardiac ward, where they continue to receive less intensive care. Although continuous cardiac monitoring is still required, patients are allowed (and encouraged) to start walking and moving regularly. Our country started relatively late in cardiac rehabilitation after heart surgery. In foreign countries, physical therapists or exercise therapists work together with patients from lower level units to help them make progress while walking and guide them on which activities to avoid after being allowed to go home. We still have a lot of work to do in this regard, and at the same time, we need to dispel the erroneous belief of patients that they dare not move after heart surgery and need to rest. Most heart disease patients can be discharged directly from the hospital after a period of time in a regular ward. They are often assigned a cardiac rehabilitation plan, including when to have a follow-up examination. They will learn more about the necessary changes in their diet, exercise, and other lifestyle factors. These changes are crucial for avoiding readmission and even ICU "second visit". So, entering the ICU represents a patient's critical condition with many changes, but it does not mean a bleak future. Most patients who enter the ICU can be smoothly transferred out, especially those who have undergone cardiac surgery, and the ICU is a necessary place for recovery. (New Society)
Edit：HAN ZHUOLING Responsible editor：CAICAI
Source：xinhuanet.com
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