The creation of a dedicated intensive care unit came from Evgeny Ivanovich Chazov and Mikhail Yakovlevich Ruda as early as in 1963 – just 2 years after the first foreign publication describing that innovative approach to managing patients with acute cardiovascular conditions. The new specialized unit located back then in the Institute of Internal Medicine at Petroverigsky lane, became the first of its kind for the nation and among the earliest globally. From the very first days, the department actively implemented such global up-to-date advances as cardiac pacing, monitoring systems with a central observation workstation, along with many others. These measures largely determined future evolvement of cardiac emergency care in this country and became the starting point in the struggle to reduce mortality in acute cardiac conditions, mainly – myocardial infarction.
On June 5, 1975, physicians of the intensive care unit in A.L. Myasnikov Cardiology Institute, the direction of academician E.I. Chazov and Prof. M.Y. Ruda were the first in the world to perform selective drug-induced lysis of a thrombus in an artery supplying the heart. This method, now known as intracoronary thrombolysis, has heralded a new era in managing patients with myocardial infarction.
A major impetus propelling further advances came about with the opening of a new facility complex including 26 buildings in 1982, where an intensive care unit project followed a special architectural plan, still considered to the state-of-the-art even now. It provided the means to hospitalize patients with acute cardiac conditions to intensive care wards directly, bypassing the emergency room, while immediate proximity of catheterization labs reduced the time to opening coronary arteries in myocardial infarction to minimum. Close collaboration with other units of the Cardiology Institute facilitating urgent management for patients of the intensive care unit has enabled the availability of operating rooms for emergency cardiovascular surgeries, open and small invasive, all around the clock. Laboratory workup, computed and magnetic resonance tomography can be performed all round the clock as well. The intensive care unit itself also has the capacities to conduct urgent point-of-care ultrasound examinations. All of the above drastically increase the quality of critical care.
That, along with other achievements, has become possible thanks to Prof. M.Y. Ruda, after whom the Russian society of cardiac emergency specialists has been named since 2019. Under his stewardship the cardiac emergency department for severe decades kept exploring many new methods of treating cardiac conditions. Unique medications developed by the National Medical Research Cardiology Institute staff – Nibentan, Refralon, Monofram, Purolase – were investigated there. Over the last decades, the intensive care unit has been successfully implementing the recent advances in cardiac emergency management, both international and domestic, including technologically sophisticated methods of diagnostics and treatment. Those include up-to-date monitoring systems, devices for mechanic circulation support, renal replacement therapy, and methods of manageable external cooling that are used in the most severe patients surviving a cardiac arrest.
One of the most important focus area of research and clinical work done by the intensive care unit staff nowadays is the development of care pathways in cardiogenic shock – a condition associated with extremely high mortality. They are developing new clinical protocols and interaction algorithms bringing together institutions from different levels involved in patient management nationwide.
Dr. Dmitry Pevzner has headed the intensive care unit since 2017.
