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(Chest. 2006;129:1061-1067.)
© 2006 American College of Chest Physicians

Intensive Care and Emergency Medicine*

Progress Over the Past 25 Years

Jean-Louis Vincent, MD, PhD; Mitchell P. Fink, MD, FCCP; John J. Marini, MD; Michael R. Pinsky, MD, FCCP; William J. Sibbald, MD, FCCP; Mervyn Singer, MD; Peter M. Suter, MD; Deborah Cook, MD; Paul E. Pepe, MD and Timothy Evans, MD

* From the Department of Intensive Care (Dr. Vincent), Erasme Hospital, Free University of Brussels, Belgium; Department of Critical Care Medicine (Drs. Fink and Pinsky), University of Pittsburgh School of Medicine, Pittsburgh PA; Department of Pulmonary and Critical Care Medicine (Dr. Marini), Regions Hospital, University of Minnesota, St Paul MN; Department of Medicine (Dr. Sibbald), Sunnybrook & Women’s College Health Sciences Center, Toronto, Canada; Department of Intensive Care Medicine (Dr. Singer), University College, London, UK; Department of Surgical Intensive Care (Dr. Suter), Hôpital Cantonal Universitaire, Geneva, Switzerland; Department of Critical Care Medicine (Dr. Cook), McMaster University Medical Center, Hamilton, Canada; Emergency Services Department (Dr. Pepe), Parkland Health & Hospital System and the University of Texas Southwestern Medical Center, Dallas, TX; and Department of Intensive Care Medicine (Dr. Evans), Royal Brompton Hospital, London, UK.

Correspondence to: Jean-Louis Vincent, MD, PhD, Department of Intensive Care Medicine, Erasme University Hospital, Route de Lennik 808, 1070 Brussels, Belgium; e-mail: jlvincen{at}ulb.ac.be

Abstract

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.

Key Words: ARDS • cardiopulmonary resuscitation • cardiovascular care • critical care • intensive care • invasive monitoring • mechanical ventilation • multiorgan failure • polytrauma • sepsis






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