MICU vs CCU

[studentofsdn]

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For my sub-I, would MICU or CCU be more beneficial for my education if I'm going into anesthesia? Thanks

 

[Instatewaiter]

Both would be very helpful but I vote for CCU.

 

[getdown]

For my sub-I, would MICU or CCU be more beneficial for my education if I'm going into anesthesia? Thanks

The big killers in Anesthesia are cardiac and pulmonary complications. Being familiar and comfortable in dealing with cardiac pathology including arrhythmias, MI, CAD, stents, CHF, pulmonary hypertension, hypertrophic cardiomyopathy as well as their management would be very helpful. Determining if a patient is "optimized" is a daily occurrence in the ORs.

 

[studentofsdn]

The big killers in Anesthesia are cardiac and pulmonary complications. Being familiar and comfortable in dealing with cardiac pathology including arrhythmias, MI, CAD, stents, CHF, pulmonary hypertension, hypertrophic cardiomyopathy as well as their management would be very helpful. Determining if a patient is "optimized" is a daily occurrence in the ORs.

Makes sense. At what level are these issues also seen in the MICU? Or are they all transferred out to/go straight to CCU first?

 

[Radetzky]

Micu. Anesthesia and critical care go hand in hand.

 

[getdown]

Makes sense. At what level are these issues also seen in the MICU? Or are they all transferred out to/go straight to CCU first?

Well CCU will likely only take patient with active cardiac disease like STEMIs and stuff. However, that doesn't mean that the patients in the MICU won't have cardiac history ... just that they have active non-cardiac disease that would land them in MICU.

In the end you'll learn a lot from either rotation. You'll do more vent management in MICU as well as deal with pulmonary diseases like COPD exacerbation, CHF exacerbation, DKA, GI bleeds, cirrhotics etc. However, like I said earlier, cardiac disease is something we as Anesthesiologists deal with and look for in a regular basis in patients going for OR. Plus having a basic understanding of echos and risk stratification of cardiac patients (RCRI criteria) and talking with cardiologists about cardiac clearance will be beneficial.