Physicians in the intensive care unit
Who they are, what they do and which devices they use: a research-based profile for recruiting this target group for MedTech and pharma projects.
Overview
Physicians in the intensive care unit monitor and treat patients with life-threatening impairment of vital or organ functions that are supported or maintained by intensive care procedures. They lead and coordinate interdisciplinary and interprofessional treatment, use scoring systems and manage admission, transfer and discharge. Their procedures include airway management, invasive and non-invasive ventilation including weaning, tracheostomy, arterial and central venous cannulation, renal replacement therapy, extracorporeal lung support and mechanical circulatory support. For diagnostics they use patient monitoring, ultrasound, focused echocardiography and intracranial pressure monitoring. They are also responsible for sedation, pain and delirium management, treatment of infections and sepsis, and changes of treatment goals according to the patient's wishes.
Profession by country
Fields of use and typical tasks
Intensive care medicine
Evidence from: DE, AT, CH
- Provide medical care for and monitor critically ill patients
- Decide on transfers during the ward round
- Ventilate patients with insufficient breathing via endotracheal tube and ventilator
- Manage artificial nutrition via central venous catheters or feeding tubes
- Hold conversations with relatives
- Provide intensive care for patients after cardiac, thoracic, vascular, neurosurgical and abdominal surgery
Cardiac surgical intensive care
Evidence from: DE, AT, CH
- Postoperative intensive care of adult patients after elective cardiac, thoracic and vascular surgery
- Management of mechanical circulatory support with intra-aortic balloon pump, temporary left or right ventricular support systems and veno-arterial ECMO
- Treatment of patients with durable ventricular assist devices and after thoracic organ transplantation
- Pre- and postoperative treatment of acute aortic dissection including monitoring of cerebrospinal fluid pressure after aortic surgery
- Advanced haemodynamic monitoring with transpulmonary thermodilution and transthoracic and transoesophageal echocardiography
- Lung-protective ventilation with protocol-based weaning, bronchoscopy and dilatational tracheostomy
Neonatology and paediatric intensive care
Evidence from: DE, AT, CH
- Provide initial care and stabilisation for preterm and sick newborns directly in the delivery room together with obstetrics
- Treat respiratory disorders with invasive and non-invasive ventilation, high-flow oxygen therapy and nitric oxide ventilation, and administer surfactant using less invasive techniques
- Place central venous and arterial catheters and manage differentiated circulatory therapy
- Perform therapeutic hypothermia, aEEG recordings, exchange transfusions and neonatal dialysis
- Order ultrasound of the brain and abdominal organs as well as X-ray and MRI, and prescribe phototherapy for neonatal jaundice
- Conduct daily ward rounds and inform parents at admission, discharge, acute changes and in weekly physician consultations
Specializations
Devices and systems they use
- ECMO system
- Intensive care ventilator
- Ventricular assist device (VAD)
- Intra-aortic balloon pump
- Patient monitor
- Inhaled nitric oxide delivery system (iNO)
- Continuous renal replacement therapy (CRRT) machine
- Flexible endoscope
- Pulmonary artery catheter
- Central venous catheter
- Echocardiography system
- Advanced haemodynamic monitoring system
- Infant incubator
- Ultrasound system
- Arterial catheter
- Electroencephalography (EEG) system
Who they work with
- Intensive care nurses
- Physiotherapists
- Speech and language therapists
- Respiratory therapists
- Physicians of the specialties treating the underlying disease
Frequently asked questions
Which devices and procedures do intensive care physicians manage?
According to the training content: invasive and non-invasive ventilation, renal replacement therapy, extracorporeal lung support, mechanical circulatory support, external pacemakers as well as patient monitoring, ultrasound and echocardiography.
Who coordinates treatment in the intensive care unit?
Intensive care physicians lead and coordinate interdisciplinary and interprofessional treatment and coordinate with the physicians treating the underlying disease.
Which professional groups do they work with?
One described intensive care unit names a multiprofessional team of physicians and nurses and a therapeutic team of physiotherapists, speech therapists and respiratory therapists (example of one facility).
Which conditions are in focus?
The training names among others ARDS, respiratory infections, sepsis, shock, heart failure, renal failure, severe neurological diseases and pregnant patients.
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Related target groups
Same work area
Same specialty
Sources
- eLogbuch Zusatz-Weiterbildung Intensivmedizin, Sächsische Landesärztekammer (DE)
- Zentrum für Intensivmedizin, Universitätsmedizin Essen (DE)
- Informationsfaltblatt Internistische Intensivstation, Klinikum rechts der Isar der Technischen Universität München, Klinik für Innere Medizin II (DE)
- Intensivmedizin: Schwerpunkte und Leistungen der Klinik für Anästhesiologie und operative Intensivmedizin, Kepler Universitätsklinikum Linz (AT)
- Informationen für Angehörige: Intensivstation, Universitätsspital Basel (CH)
- Intensive Care Medicine, Deutsches Herzzentrum der Charité (DHZC), Klinik für Kardioanästhesiologie und Intensivmedizin (DE)
- Qualitätsbericht Herzzentrum 2023, Medizinische Hochschule Hannover (DE)
- Weiterbildungskonzept Institut für Intensivmedizin, Universitätsspital Zürich, Institut für Intensivmedizin (CH)
- Neonatologie, Klinik für Kinder- und Jugendmedizin, Philipps-Universität Marburg, Fachbereich Medizin, Universitätsklinikum Marburg (DE)
- Weiterbildungscurriculum Schwerpunkt Neonatologie, Universitätsklinikum Leipzig, Abteilung für Neonatologie (DE)
- Stationsbroschüre Perinatalzentrum: Informationen für Eltern von Früh- und Neugeborenen, Universitätsklinikum Essen, Perinatalzentrum (DE)
- Neonatologie: Schwerpunkte und Leistungen, Kepler Universitätsklinikum Linz (AT)
- Presseinformation Neonatologie heute, Klinikum Wels-Grieskirchen (AT)
- Stationsbüchlein Neonatologie, Klinikum Wels-Grieskirchen, Abteilung für Kinder- und Jugendheilkunde (AT)
- Abteilung für Intensivmedizin und Neonatologie: Informationen für Eltern, Universitäts-Kinderspital Zürich, Eleonorenstiftung (CH)
- Neonatologie: Informationen für Eltern, Kantonsspital Aarau, Kinderspital, Neonatologie (CH)
- Critical Care Medicine Fellowship: Clinical Training, University of Maryland Medical Center (US)
- Critical Care Medicine Fellowship: Curriculum Overview, Henry Ford Health (US)
- Critical Care Fellowship: Clinical Rotations, Baylor College of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine (US)
- Section Highlight: CVICU, University of Utah Health, Division of Cardiothoracic Surgery (US)