Department of Critical Cardiology and Rehabilitation

Intensive Cardiac Care Unit

Quick Facts

The Unit has 13 beds with centralized monitoring for intensive cardiological care, and can count on 12 cardiologists, 24 nurses and a nurse coordinator dedicated to inpatient care and 1 clerk. In the last year counted, 795 total hospitalizations were carried out, for the majority (68%) with access from the Emergency Department, the 118 service, or transferred from other centers ("spoke"). The remaining admissions from inpatient wards and interventional laboratories.

U.O. has 13 beds with centralized monitoring for intensive cardiological care. On average, almost 1,000 patients suffer from acute cardiological diseases (acute myocardial infarction, unstable angina, cardiovascular decompensation and shock, brady- and tachi-arrhythmias, systemic and pulmonary embolisms) and internistic (respiratory, circulatory and renal insufficiency). In addition to the traditional tasks of the Coronary Units, the department manages all clinical emergencies of the Monzino, including those of non strict specialist cardiological relevance.

In particular, the medical and paramedical staff of the U.O. has acquired experience in the most modern techniques for the diagnosis and treatment of all acute cardiological diseases and their complications: primary coronary angioplasty in the treatment of acute myocardial infarction (in collaboration with the UU.OO. of Interventional Cardiology), aortic counterpulsation in cardiogenic shock, treatment of severe heart failure and acute renal failure by techniques replacing renal function (hemodialysis, ultrafiltration, hemofiltration), temporary cardio-electrical stimulation (for brady-and tachycardia) and mechanical ventilatory assistance, both invasive and non-invasive, in patients with acute respiratory failure.
Thanks to the logistical position of the department, the integration with the various U.O. and the constant availability of numerous specialists, our U.O. has constantly (24 hours a day) all the most modern diagnostic procedureshigh-tech and specialized therapies (transesophageal ultrasound, hemodynamics, electrophysiology, cardiosurgery, etc.), both in the field of treatment of acute myocardial infarction, and all other critical pathologies.

In collaboration with the U.O Decompensation and Clinical Cardiology, the Cardiological Intensive Care Unit deals with the treatment of patients with congestive, refractory and non-reactive heart failure, which, due to their clinical condition, require procedures replacing renal function, in particular ultrafiltration and extracorporeal hemofiltration. In this field he has gained, in more than 25 years of activity, considerable clinical experience (probably the most important case studies in the world in the application of these methods in the cardiological field) and developed clinical treatment protocols.

In addition, in collaboration with the Interventional Cardiology Units, preventive treatment of acute renal failure from exposure to contrast during interventional cardiology procedures is routinely carried out. This aim is pursued through various methods of treatment, both pharmacological and not (hemofiltration, controlled hydration), customized in relation to the severity of the patient’s risk and the clinical context.

UTIC has also become a reference centre for the diagnosis and treatment of pericardial effusions. The pericardiocentesis with percutaneous technique, refined on the basis of a wide range of cases, is performed under direct echocardiographic and radioscopic control in the operating room, thus ensuring the highest degree of clinical and procedural monitoring with a low level of invasiveness. In collaboration with the Cardiology Unit of the European Institute of Oncology, a protocol for intrapericardial chemotherapy treatment in cases of pericardial effusion of a neoplastic nature has also been developed.

Research Activities

  • The scientific production of UTIC is mainly focused on the study of acute myocardial infarction, congestive heart failure and cardio-interactionrenal, contrast nephropathy and new risk biomarkers in acute cardiovascular disease. To this end, the Unit relies on the collaboration of the other Operational Units of the Institute, in particular the Decompensation Unit, Interventional Cardiology, Postoperative Intensive Care (TIPO)of the Laboratory of Cellular Biology and Biochemistry of Atheotrombosis and outside the Institute in particular the Cardiology Unit of IEO, IFOM and others. He also participates in numerous international multicenter studies concerning acute coronary syndromes.

Other Activities

  • Educational activities

    UTIC doctors provide their collaboration with the Department of Clinical Sciences and Community Section of Cardiovascular Diseases of the University of Milan. The UTIC welcomes specialists in Cardiology and provides the logistics and tutors necessary for the preparation of the theses of the Specializations. The doctors of the Unit also carry out teaching activities in the Specialty School. Finally, the Unit regularly welcomes medical visitors from various Italian and foreign institutions, for educational purposes.