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<p>Cardiovascular intensive care medicine plays a pivotal role in the management of critically ill patients. While the early coronary units of the 1960s were primarily focused on the monitoring of arrhythmias, contemporary care must adress an increasingly older patient population with multiple comorbidities and a&#xa0;higher prevalence of multiorgan failure [<CitationRef CitationID="CR1">1</CitationRef>, <CitationRef CitationID="CR2">2</CitationRef>]. Although advances in interventional procedures have considerably broadened treatment options, they have also heightened the need for structured guidelines and standards, as emphasized by the regulations of the Federal Joint Committee (G-BA), the recommendations of professional societies and position statements of the German Interdisciplinary Association for Critical Care and Emergency Medicine (DIVI) [<CitationRef AdditionalCitationIDS="CR4 CR5" CitationID="CR3">3</CitationRef>–<CitationRef CitationID="CR6">6</CitationRef>]. However, for high-risk patients in cardiovascular intensive care medicine, particularly those with cardiogenic shock, severe heart failure, pronounced hemodynamic instability, impending multiorgan failure, high-risk pulmonary embolism, septic cardiomyopathy or in post-cardiac arrest syndrome (PCAS), general standards are insufficient. Cardiovascular high risk patients require a highly structured treatment continuum, extending from acute and emergency management, through intensive care stabilization to organ support and coordinated regional networks. Effective multidisciplinary care also requires specialized structures, optimized processes and systematic outcome measurement. These requirements include clearly defined structural elements such as 24/7 catheterization laboratory availability, integrated shock teams, explicit criteria for mechanical organ support and access to mobile extracorporeal membrane oxygenation (ECMO) services. Furthermore, the continued development of cardiovascular intensive care medicine requires an interdisciplinary roadmap for training, network development and the integration of innovative care structures (including telemedicine and artificial intelligence) in order to guide its future-directed strategic orientation. This will be essential to ensure the long-term provision of multidisciplinary, highly specialized treatment of this increasingly ill patient population while maintaining the highest possible standard of care.</p>

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Kardiovaskuläre Intensivmedizin als integraler Bestandteil intensivmedizinischer Zentren (G-BA): Strukturelle Ausrichtung, Anforderungen und Entwicklungsperspektiven

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月14日

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  • Birgit Markus,
  • Stephan Baldus,
  • Norbert Frey,
  • Christian Schulze,
  • Nikolaus Marx,
  • Malte Kelm,
  • Daniel Dürschmied,
  • Bernhard Schieffer

摘要

Cardiovascular intensive care medicine plays a pivotal role in the management of critically ill patients. While the early coronary units of the 1960s were primarily focused on the monitoring of arrhythmias, contemporary care must adress an increasingly older patient population with multiple comorbidities and a higher prevalence of multiorgan failure [1, 2]. Although advances in interventional procedures have considerably broadened treatment options, they have also heightened the need for structured guidelines and standards, as emphasized by the regulations of the Federal Joint Committee (G-BA), the recommendations of professional societies and position statements of the German Interdisciplinary Association for Critical Care and Emergency Medicine (DIVI) [3–6]. However, for high-risk patients in cardiovascular intensive care medicine, particularly those with cardiogenic shock, severe heart failure, pronounced hemodynamic instability, impending multiorgan failure, high-risk pulmonary embolism, septic cardiomyopathy or in post-cardiac arrest syndrome (PCAS), general standards are insufficient. Cardiovascular high risk patients require a highly structured treatment continuum, extending from acute and emergency management, through intensive care stabilization to organ support and coordinated regional networks. Effective multidisciplinary care also requires specialized structures, optimized processes and systematic outcome measurement. These requirements include clearly defined structural elements such as 24/7 catheterization laboratory availability, integrated shock teams, explicit criteria for mechanical organ support and access to mobile extracorporeal membrane oxygenation (ECMO) services. Furthermore, the continued development of cardiovascular intensive care medicine requires an interdisciplinary roadmap for training, network development and the integration of innovative care structures (including telemedicine and artificial intelligence) in order to guide its future-directed strategic orientation. This will be essential to ensure the long-term provision of multidisciplinary, highly specialized treatment of this increasingly ill patient population while maintaining the highest possible standard of care.