[TJS4] TSCCM-JSICM Symposium4
Perioperative critical care

[TJS4-1] How to start up surgical ICU by internal physician intensivist

Go Haraguchi¹, Chieko Mitaka², Koichi Matsuo³, Takumi Nagao¹, Katsuaki Otsuki⁴, Morimasa Takayama⁵, Mitsuaki Isobe⁵ (1.Division of Intensive Care Unit, Sakakibara Heart Institute, Japan, 2.Department of Anesthesiology, Juntendo University Hospital, Japan, 3.Division of Intensive Care Unit, New Tokyo Hospital, Japan, 4.Division of Intensive Care Unit, Tsuchiura Kyodo General Hospital, Japan, 5.Department of Cardiovascular Medicine, Sakakibara Heart Institute, Japan)

【 ライブ配信】

There are many hospitals without ICU in Japan. Moreover, there are so many ICU without presence of intensivists. Japanese government required existence of ICU for definition of advanced acute care hospital, large number of hospitals wanted to hire intensivist as for. For this reason, I started up three ICU in these 6 years. First, I started to be permanently stationed in the surgical ICU especially for cardiac surgery (650/year) from April 2014. I presented the comparison of the year with or without presence of intensivist in the 43th annual meeting of the JSICM. Next, I started general ICU (about 80% of patients were surgical) in 800 beds hospital with emergency center from April 2016 at the same time as reorganization of the hospital. Last, I started the surgical ICU especially for cardiac surgery (1200/year) from Nov 2017. The presence of physician intensivist in surgical ICU profits at least 3points, 1) the treatment progress regardless of surgeon’s absence 2) the care from both surgeon’s and physician’s viewpoints 3) a relief for all co-medicals in my experience. But then, the biggest disadvantage of physician intensivist is that I cannot do surgical procedures including re-operation, treatment of massive hemorrhage. Of course, a cooperation between all the staff of ICU is most beneficial and important thing.