Seniors in Cardiac ICU Need Special Care

Issues to be managed include chronic conditions, physical frailty and mental confusion

Older adults need special attention when admitted to cardiac intensive care units, according to a new scientific statement from the American Heart Association. “Pre-existing chronic conditions, physical frailty, mental confusion and the use of multiple medications are among the issues caregivers should consider in managing older adults with acute heart conditions,” said Mauricio G. Cohen, M.D., professor of medicine and director of the Cardiac Catheterization Laboratory at the Miller School of Medicine.

Dr. Cohen was the senior author of the report, which was published in the journal Circulation.

Special Considerations

“A thoughtful approach to critical care management of older patients with cardiovascular disease is necessary, because they may be more vulnerable than younger patients in the cardiac intensive care unit (CICU),” Dr. Cohen said. “Older patients tend to take longer to recover, and may not be able to regain their prior abilities. In some cases, further treatments may no longer be effective, and physicians will need to discuss these situations with patients and family members.”

Multiple procedures, new medications, sensory overload, sleep deprivation, prolonged bed rest, and malnourishment are usually inherently disruptive to older patients regardless of the excellence of cardiovascular care, he added.

“As the nation’s older adult population grows, the influence of these geriatric syndromes on the health care system will be magnified in the years to come,” Dr. Cohen said. “We need to consider these issues and undertake further investigations to integrate the different requirements of older adults into overall CICU models of care.”

UNIVERSITY OF MIAMI MEDICINE
SPRING 2020