The COVID-19 pandemic has presented a major unanticipated stress on the workforce, organizational structure, systems of care, and critical resource supplies. To ensure provider safety, to maximize efficiency, and to optimize patient outcomes, health systems need to be agile. Critical care cardiologists may be uniquely positioned to treat the numerous respiratory and cardiovascular complications of the SARS-CoV-2 and support clinicians without critical care training who may be suddenly asked to care for critically ill patients. This review draws upon the experiences of colleagues from heavily impacted regions of the United States and Europe, as well as lessons learned from military mass casualty medicine. This review offers pragmatic suggestions on how to implement scalable models for critical care delivery, cultivate educational tools for team training, and embrace technologies (e.g., telemedicine) to enable effective collaboration despite social distancing imperatives.
Driven by evolving patient demographics and disease burdens over the past several decades, the demands placed on the cardiac intensive care unit have steadily increased. Originally born out of the need for post-infarction arrhythmia monitoring, the modern cardiac intensive care space is now encountering progressively more complex patients with multisystem organ failure and, increasingly, complex mechanical circulatory support. This complexity has fueled a demand for specifically trained cardiac intensivists, and many different training pathways have emerged nationwide. In this article, we provide an overview of the evolution, landscape, training, and future of the subspecialty of cardiac critical care.
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