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Suárez-de-la-Rica, G. Aguilar, E. Maseda" "autores" => array:3 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Suárez-de-la-Rica" "email" => array:1 [ 0 => "alejandro.suarez.delarica@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "G." "apellidos" => "Aguilar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "E." "apellidos" => "Maseda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Cuidados Críticos Quirúrgicos, Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Cuidados Críticos, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Valencia, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cuidados intensivos en España" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with great interest the special article published in the <span class="elsevierStyleSmallCaps">Spanish Journal of Anaesthesiology and Critical Care</span> on the situation regarding intensive care in Spain.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In Spain, unlike other countries, intensive care medicine is a primary specialty, and there is some controversy regarding multidisciplinary access to intensive care. Recently, in a letter addressed to the chairman of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), the European Board of Anaesthesiology (EBA) of the European Union of Medical Specialists (UEMS) endorsed the SEDAR’s position, indicating that intensive care medicine is an essential part of the competencies of anaesthesiologists, and arguing that Spanish anaesthesiologists have the skills needed to treat critically ill patients. Furthermore, the European Society of Anaesthesiology (ESA) recently changed its name to the European Society of Anaesthesiology and Intensive Care (ESAIC).</p><p id="par0010" class="elsevierStylePara elsevierViewall">The EBA of the UEMS has also established the Anaesthesiology European Training Requirements (Anaesthesiology ETR), defining intensive care medicine and emergency medicine as basic domain of competence in a European specialist in anaesthesiology.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> This same document recommends that specialised training in anaesthesiology should last for at least 5 years, of which at least 1 year should be spent at an intensive care unit. As the authors of the article state, full competence in intensive care medicine cannot be acquired with the 4 years of training currently included in the Spanish MIR [medical residency] programme, so, as in other specialties, specific training is required after completing the official MIR programme.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In the section on “need for and benefits of anaesthesia intensive care”, the authors explain that these units are more efficient, insofar as the presence of specialists with wide-ranging competences helps optimize the workforce. In contrast, we believe that to ensure the excellence of care in the critical patient, doctors must be exclusively, or nearly exclusively, dedicated to their treatment. Intensive care should be considered a continuum of care in which intensive care doctors (regardless of their primary specialty) initially identify and manage potentially seriously ill patients before admission to the ICU, and also treat them after discharge to minimize the physical and psychological consequences of their ICU stay.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> A study of 114,777 hospital admissions showed that 30-day mortality, readmission rates, and associated cost were all lower in patients who were part of a continuity of care strategy.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">After the meeting of the Executive Committees of the Spanish Society of Intensive and Critical Medicine and Coronary Units (SEMICYUC) and SEDAR on January 28, 2020, it was agreed to create a working team to develop interesting lines of collaboration for both societies. We believe that this agreement is an important opportunity to create bidirectional bridges that can facilitate access to the specialty of intensive care medicine and anaesthesiology in trainees who have undergone a specific additional regulated training programme after completing their primary specialty residency. As the author of a recent editorial published in this journal pointed out, the current COVID-19 pandemic has highlighted the need for greater unity than ever before, and a dedication to achieving excellence of care for all our patients.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Suárez-de-la-Rica A, Aguilar G, Maseda E. Cuidados intensivos en España. Rev Esp Anestesiol Reanim. 2020. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.redar.2020.06.002">https://doi.org/10.1016/j.redar.2020.06.002</span></p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Situación de los cuidados intensivos en España" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Monedero" 1 => "D. Paz-Martín" 2 => "F. Barturen" 3 => "L. Fernández-Quero Bonilla" 4 => "J. Cardona Peretó" 5 => "C.A. Sánchez Pérez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redar.2020.01.007" "Revista" => array:5 [ "tituloSerie" => "Rev Esp Anestesiol Reanim" "fecha" => "2020" "volumen" => "67" "paginaInicial" => "147" "paginaFinal" => "152" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "European Board of Anaesthesiology (EBA UEMS). Anaesthesiology European Training Requirements (new UEMS European Training Requirements Anaesthesiology 2018). Available from: <a target="_blank" href="http://www.eba-uems.eu/resources/PDFS/EPD/ETR-Anaesthesiology-2018.pdf">http://www.eba-uems.eu/resources/PDFS/EPD/ETR-Anaesthesiology-2018.pdf</a>." ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The continuum of critical care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.L. 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Maseda" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Anestesiol Reanim" "fecha" => "2020" "volumen" => "67" "paginaInicial" => "225" "paginaFinal" => "226" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006700000009/v1_202012020716/S2341192920301396/v1_202012020716/en/main.assets" "Apartado" => array:4 [ "identificador" => "66474" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter to the Director" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006700000009/v1_202012020716/S2341192920301396/v1_202012020716/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192920301396?idApp=UINPBA00004N" ]
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Letter to the Director
Intensive care in Spain
Cuidados intensivos en España
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Revista Española de Anestesiología y Reanimación (English Version). 2021;68:430-110.1016/j.redare.2020.08.011
P. Monedero, D. Paz-Martín, F. Barturen, J. Cardona Peretó, C.A. Sánchez Pérez, R. Cabadas Avión, F. García-Montoto Pérez, R. González Celdrán, N. Ojeda Betancor, O.M. Padrón Ruiz, A. Pérez Carbonell, C. Soria Gulina, E. Tamayo Gómez, V. Torres Pedrós, M. Heredia Rodríguez, R. Peyró García