The Future of Cardiothoracic Surgical Critical Care Medicine as a Medical Science: A Call to Action

Medicina, 2023 · DOI: 10.3390/medicina59010047 · Published: December 27, 2022

Simple Explanation

Cardiothoracic surgical critical care medicine (CT-CCM) is a discipline focused on the care of patients around the time of heart and chest surgeries. As the population ages and more people have chronic diseases, the need for CT-CCM is expected to increase. This article reviews the current state of CT-CCM, proposes goals for the future, and identifies gaps in knowledge that need further scientific study. It emphasizes the importance of CT-CCM as a distinct area within critical care and cardiothoracic surgery. The review offers guiding principles and a call-to-action plan to promote CT-CCM. It also evaluates scientific data, points out where knowledge is lacking, and suggests directions for future research.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
CT-CCM faces barriers to knowledge expansion due to historical factors, scientific limitations, systemic issues, educational gaps, and financial constraints.
2
Current standards of practice in CT-ICUs often rely on data from non-CT-ICU patients, which may not be appropriate due to the unique pathophysiology and patient populations in CT-CCM.
3
A call to action includes forming a governing body, establishing a scientific journal, securing research funding, expanding conferences, and standardizing CT-CCM training.

Research Summary

Cardiothoracic surgical critical care medicine (CT-CCM) is a medical discipline centered on the perioperative care of diverse groups of patients, and its utilization is likely to escalate with the aging population and increased burden of chronic diseases. The review concentrates on CT-CCM as its own subspeciality and provides aspirational goals for practitioners and scientists, offering guiding principles and a call-to-action agenda, while identifying knowledge gaps and recommending future scientific endeavors. Significant knowledge gaps exist in areas such as cardiac surgery-associated acute kidney injury, delirium, pharmacotherapy, transfusion medicine, paralysis after aortic aneurysm surgery, and the implementation of cardiac surgical unit-advanced life support.

Practical Implications

Establish Centralized Governing Body

Formation of a goal setting, centralized governing body, such as CT-CCM specific society will help unify the professionals.

Promote CT-CCM Research

Securement of funding and development of grant programs specifically geared towards CT-CCM research will foster innovation.

Standardize CT-CCM Training

Establishment of a standardized CT-CCM training curriculum, continuing education, and certification will improve patient care.

Study Limitations

1
The review identifies selected knowledge gaps but is not exhaustive.
2
The recommendations are based on the authors' perspectives and may not represent a consensus view.
3
The review does not include a detailed analysis of the cost-effectiveness of the proposed actions.

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