The future of critical care.
OBJECTIVE
This review will examine the current scenario of critical care medicine and describe trends for the future.


RESULTS
Critical care is facing increasing demands due to an aging population and the relative lack of intensivists. Quality and healthcare costs are becoming day-to-day issues. The future will see an increasing use of protocols, virtual consultations, and regionalized care for more complex and common diseases such as trauma and acute lung injury. Intensivists will be skeptical due to difficulties in demonstrating benefits of any new drug, ventilator, monitor, or laboratory test, when added to basic, life-saving treatments. We do not believe that a 'magic bullet' is soon to come, and emphasis will be placed on cost restraining. Computers will have an increasing presence in critical care, now eased by a user group that is increasingly adept at using them. However, ICUs will still rely on human resource, making the myth of a fully automated ICU bed unlikely.


CONCLUSIONS
The future of ICU will rely on management and teamwork. The costs of critical care will be restrained through the use of better management, guidelines, and skepticism regarding new technologies and drugs. Policy makers will help society build better strategies for critical care services.
Amaral
Andre Carlos Kajdacsy-Balla
AC
Department of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.
Rubenfeld
Gordon David
GD
D003422:Critical Care / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units / Q000639:trends*