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Medicina
Special Issues
Cardiothoracic Surgical Critical Care: A Future of Distinction
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Cardiothoracic Surgical Critical Care: A Future of Distinction

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Intensive Care/ Anesthesiology".

Deadline for manuscript submissions: closed (20 August 2022) | Viewed by 13131

Special Issue Editors

Dr. Michael K. Essandoh

E-Mail Website
Guest Editor
Department of Anesthesiology, Ohio State University Medical Center, Columbus, OH, USA
Interests: cardiothoracic anesthesiology; transesophageal echocardiography; lung transplantation; point-of-care ultrasound; ECMO; mechanical circulatory support
Dr. Amar M. Bhatt

E-Mail Website
Guest Editor
Department of Anesthesiology, Ohio State University Medical Center, Columbus, OH, USA
Interests: cardiothoracic anesthesiology; transesophageal echocardiography; lung transplantation; point-of-care ultrasound; ECMO; mechanical circulatory support

Special Issue Information

Dear Colleagues,

Cardiothoracic surgical intensive care units (CTICU) are highly specialized hospital wards responsible for providing life-saving monitoring and therapies to a very specific patient population. Post-operative care of cardiothoracic surgical patients has evolved along with advances in cardiothoracic surgery since the 1950s. With technological developments in mechanical circulatory and respiratory support systems over the last two decades, the complexity of critical care has also increased.1-5 More recently, anesthesiologists with exposure to cardiac surgical procedures and subspecialty trained in critical care have become an integral part of these units.

This has been brought to the forefront during the coronavirus disease 2019 (COVID-19) pandemic, with thousands of patients being supported with extracorporeal membrane oxygenation (ECMO) worldwide, requiring around the clock multidisciplinary expertise in management.6  The future of cardiothoracic surgical critical care is one of distinction and with this Special Issue, we hope to address knowledge gaps by displaying new scientific research pursued by specialists trained in cardiothoracic surgical critical care. We hope to address contemporary advances such as cardiothoracic surgical updates, mechanical circulatory support devices, single and multi-organ transplantation, echocardiography and issues pertinent to critical care such as physician burnout, cost-effective interdisciplinary care teams and ethical concerns.

It is our privilege to cordially invite researchers and practitioners to share their expertise and submit new ideas and recent cutting-edge research to this unique Special Issue dedicated to “Cardiothoracic Critical Care: A Future of Distinction”.

Dr. Michael K. Essandoh
Dr. Amar M. Bhatt
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiothoracic critical care
  • mechanical circulatory support
  • point-of-care echocardiography
  • lung transplantation
  • medical ethics
  • physician burnout
  • anesthesiology critical care

Published Papers (5 papers)

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Editorial

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2 pages, 203 KiB  
Editorial
Introduction to the Special Issue—Cardiothoracic Surgical Critical Care: A Future of Distinction
by Amar M. Bhatt and Michael K. Essandoh
Medicina 2022, 58(12), 1781; https://doi.org/10.3390/medicina58121781 - 03 Dec 2022
Viewed by 1007
Abstract
Critical care after cardiothoracic surgery is an inseparable component of any successful surgical program addressing intrathoracic pathologies, including heart failure treatment with mechanical circulatory support, and respiratory failure requiring extracorporeal membrane oxygenation (ECMO) therapy [...] Full article
(This article belongs to the Special Issue Cardiothoracic Surgical Critical Care: A Future of Distinction)

Review

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33 pages, 2593 KiB  
Review
The Future of Cardiothoracic Surgical Critical Care Medicine as a Medical Science: A Call to Action
by Rafal Kopanczyk, Jesse Lester, Micah T. Long, Briana J. Kossbiel, Aaron S. Hess, Alan Rozycki, David R. Nunley, Alim Habib, Ashley Taylor, Hamdy Awad and Amar M. Bhatt
Medicina 2023, 59(1), 47; https://doi.org/10.3390/medicina59010047 - 27 Dec 2022
Viewed by 5581
Abstract
Cardiothoracic surgical critical care medicine (CT-CCM) is a medical discipline centered on the perioperative care of diverse groups of patients. With an aging demographic and an increase in burden of chronic diseases the utilization of cardiothoracic surgical critical care units is likely to [...] Read more.
Cardiothoracic surgical critical care medicine (CT-CCM) is a medical discipline centered on the perioperative care of diverse groups of patients. With an aging demographic and an increase in burden of chronic diseases the utilization of cardiothoracic surgical critical care units is likely to escalate in the coming decades. Given these projections, it is important to assess the state of cardiothoracic surgical intensive care, to develop goals and objectives for the future, and to identify knowledge gaps in need of scientific inquiry. This two-part review concentrates on CT-CCM as its own subspeciality of critical care and cardiothoracic surgery and provides aspirational goals for its practitioners and scientists. In part one, a list of guiding principles and a call-to-action agenda geared towards growth and promotion of CT-CCM are offered. In part two, an evaluation of selected scientific data is performed, identifying gaps in CT-CCM knowledge, and recommending direction to future scientific endeavors. Full article
(This article belongs to the Special Issue Cardiothoracic Surgical Critical Care: A Future of Distinction)
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12 pages, 347 KiB  
Review
Developing Cardiothoracic Surgical Critical Care Intensivists: A Case for Distinct Training
by Rafal Kopanczyk, Micah T. Long, Sree V. Satyapriya, Amar M. Bhatt and Michael Lyaker
Medicina 2022, 58(12), 1865; https://doi.org/10.3390/medicina58121865 - 17 Dec 2022
Cited by 1 | Viewed by 1435
Abstract
Cardiothoracic surgical critical care medicine is practiced by a diverse group of physicians including surgeons, anesthesiologists, pulmonologists, and cardiologists. With a wide array of specialties involved, the training of cardiothoracic surgical intensivists lacks standardization, creating significant variation in practice. Additionally, it results in [...] Read more.
Cardiothoracic surgical critical care medicine is practiced by a diverse group of physicians including surgeons, anesthesiologists, pulmonologists, and cardiologists. With a wide array of specialties involved, the training of cardiothoracic surgical intensivists lacks standardization, creating significant variation in practice. Additionally, it results in siloed physicians who are less likely to collaborate and advocate for the cardiothoracic surgical critical care subspeciality. Moreover, the current model creates credentialing dilemmas, as experienced by some cardiothoracic surgeons. Through the lens of critical care anesthesiologists, this article addresses the shortcomings of the contemporary cardiothoracic surgical intensivist training standards. First, we describe the present state of practice, summarize past initiatives concerning specific training, outline why standardized education is needed, provide goals of such training standardization, and offer a list of desirable competencies that a trainee should develop to become a successful cardiothoracic surgical intensivist. Full article
(This article belongs to the Special Issue Cardiothoracic Surgical Critical Care: A Future of Distinction)
15 pages, 1034 KiB  
Review
Extracorporeal Cardiopulmonary Resuscitation: A Narrative Review and Establishment of a Sustainable Program
by Chris M. Cassara, Micah T. Long, John T. Dollerschell, Floria Chae, David J. Hall, Gozde Demiralp, Matthew J. Stampfl, Brittney Bernardoni, Daniel P. McCarthy and Joshua M. Glazer
Medicina 2022, 58(12), 1815; https://doi.org/10.3390/medicina58121815 - 09 Dec 2022
Viewed by 1686
Abstract
The rates of survival with functional recovery for out of hospital cardiac arrest remain unacceptably low. Extracorporeal cardiopulmonary resuscitation (ECPR) quickly resolves the low-flow state of conventional cardiopulmonary resuscitation (CCPR) providing valuable perfusion to end organs. Observational studies have shown an association with [...] Read more.
The rates of survival with functional recovery for out of hospital cardiac arrest remain unacceptably low. Extracorporeal cardiopulmonary resuscitation (ECPR) quickly resolves the low-flow state of conventional cardiopulmonary resuscitation (CCPR) providing valuable perfusion to end organs. Observational studies have shown an association with the use of ECPR and improved survivability. Two recent randomized controlled studies have demonstrated improved survival with functional neurologic recovery when compared to CCPR. Substantial resources and coordination amongst different specialties and departments are crucial for the successful implementation of ECPR. Standardized protocols, simulation based training, and constant communication are invaluable to the sustainability of a program. Currently there is no standardized protocol for the post-cannulation management of these ECPR patients and, ideally, upcoming studies should aim to evaluate these protocols. Full article
(This article belongs to the Special Issue Cardiothoracic Surgical Critical Care: A Future of Distinction)
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Other

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9 pages, 625 KiB  
Brief Report
A Brief History of Cardiothoracic Surgical Critical Care Medicine in the United States
by Rafal Kopanczyk, Nicolas Kumar and Amar M. Bhatt
Medicina 2022, 58(12), 1856; https://doi.org/10.3390/medicina58121856 - 16 Dec 2022
Cited by 2 | Viewed by 2934
Abstract
Cardiothoracic surgical intensive care has developed in response to advances in cardiothoracic surgery. The invention of the cardiopulmonary bypass machine facilitated a motionless and bloodless surgical field and made operations of increasing complexity feasible. By the mid-1950s, the first successful procedures utilizing cardiopulmonary [...] Read more.
Cardiothoracic surgical intensive care has developed in response to advances in cardiothoracic surgery. The invention of the cardiopulmonary bypass machine facilitated a motionless and bloodless surgical field and made operations of increasing complexity feasible. By the mid-1950s, the first successful procedures utilizing cardiopulmonary bypass took place. This was soon followed by the establishment of postoperative recovery units, the precursors to current cardiothoracic surgical intensive care units. These developments fostered the emergence of a new medical specialty: the discipline of critical care medicine. Together, surgeons and intensivists transformed the landscape of acute, in-hospital care. It is important to celebrate these achievements by remembering the individuals responsible for their conception. This article describes the early days of cardiothoracic surgery and cardiothoracic intensive care medicine. Full article
(This article belongs to the Special Issue Cardiothoracic Surgical Critical Care: A Future of Distinction)
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