Intensive care and emergency medicine: progress over the past 25 years.
Over the last quarter of a century, intensive care medicine has developed into an established hospital specialty with its own unique identity and characteristics. Significant advances have occurred, mostly in a succession of small steps rather than any dramatic leap, with many being linked to advances in health care across other disciplines. In addition, many changes have resulted from the scientific identification of the detrimental effects of certain traditional practices once thought to be therapeutic. Here, in an attempt to learn from the past and offer guidance for future progress, we detail some of the key changes in various aspects of intensive care medicine including respiratory, cardiovascular, metabolic, and nutritional care, as well as sepsis, polytrauma, organization, and management.
Vincent
Jean-Louis
JL
Department of Intensive Care Medicine, Erasme University Hospital, Route de Lennik 808, 1070 Brussels, Belgium. jlvincen@ulb.ac.be
Fink
Mitchell P
MP
Marini
John J
JJ
Pinsky
Michael R
MR
Sibbald
William J
WJ
Singer
Mervyn
M
Suter
Peter M
PM
Cook
Deborah
D
Pepe
Paul E
PE
Evans
Timothy
T
D002318:Cardiovascular Diseases / Q000628:therapy; D003422:Critical Care / Q000266:history*; D004635:Emergency Medicine / Q000266:history*; D049673:History, 20th Century; D006801:Humans; D009104:Multiple Trauma / Q000628:therapy; D051437:Renal Insufficiency / Q000628:therapy; D012140:Respiratory Tract Diseases / Q000628:therapy; D018805:Sepsis / Q000628:therapy