The Urgency and Impact of Cardiovascular Critical Care.

JOURNAL.HOUSTONMETHODIST.ORG 75 The topic of critical care may seem redundant when discussing cardiovascular medicine: After all, can't all forms of heart disease be considered critical? But the changes occurring in cardiovascular critical care are moving at such rapid-fire speed that they may well be outpacing most other medical specialties. Patients in the cardiovascular critical care unit now have access to 24/7 intensivists to monitor care and intervene at the slightest hemodynamic change. Physicians and ancillary staff can rely on in-house ethicists to help manage expectations for patients on life support and guide the medical teams through difficult endof-life interactions. Enhanced recovery after surgery pathways are being implemented to reduce surgical stress in patients and speed the return to health. New support devices are improving the delivery of cardiovascular critical care. And time-sensitive “bundled” interventions are being implemented to prevent and treat sepsis, the bane of every hospital setting. All positive changes for cardiovascular critical care, to be sure, but at what cost, and with what impact on outcomes? In this issue of the Methodist DeBakey Cardiovascular Journal, we highlight the breakthroughs, concerns, and controversies around caring for the sickest cardiac patients, all organized into the most current and pressing issues in cardiovascular critical care.