Semin Respir Crit Care Med 2016; 37(01): 001-002
DOI: 10.1055/s-0035-1570360
Preface
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Controversies and Evolving Concepts in Critical Care

Rodrigo Cartin-Ceba
1   Department of Critical Care Medicine, Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC), Mayo Clinic Arizona, Phoenix, Arizona
,
Sonal Pannu
2   Division of Pulmonary, Allergy, Critical Care, and Sleep, Ohio State University, Columbus, Ohio
,
Ognjen Gajic
3   Division of Pulmonary and Critical Care Medicine, Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC), Mayo Clinic College of Medicine, Rochester, Minnesota
› Author Affiliations
Further Information

Publication History

Publication Date:
28 January 2016 (online)

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Rodrigo Cartin-Ceba, MD, MSc
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Sonal Pannu, MD, MSc
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Ognjen Gajic, MD, MSc

The current issue of Seminars in Respiratory and Critical Care Medicine reviews a broad spectrum of controversies and evolving concepts in critical care medicine presented by leading experts in the field.

Critical care medicine is considered a young specialty that has developed from the successful use of invasive ventilation during the 1952 polio epidemic in Copenhagen. This field has rapidly grown as the need for intensive care unit (ICU) has expanded worldwide with a high proportion of acute care hospital beds that are ICU beds. In addition, critical care services utilize a high proportion of health care budgets. In 2005, critical care services in the United States were estimated to cost $81.7 billion, representing 13.4% of hospital costs, 4.1% of national health expenditures, and 0.66% of gross domestic product.

New knowledge and technology have significantly advanced the care of the critically ill. Critically ill patients have become much older, many have multiple coexisting diseases, and many undergo new and complex procedures. Fortunately, our field's growth has been accompanied by strong evidence-based knowledge, thanks to large national and international clinical-trial networks that have systematically evaluated established and new treatments in high-quality large-scale trials and in well-designed observational studies.

Despite the plethora of available new studies in critical care medicine, there are still many controversial issues. Newer studies often ignite new questions rather than solve problems. Many studies are published each year with data that conflict with others that were previously published and the application of evidence-based medicine becomes a very challenging task. However, over the past 10 years, we have witnessed the results of important studies in critical care that have predominantly shown us a few important things: less is more (unnecessary interventions can cause harm), extremes are not good (too little or too much), checklists do improve outcomes, and multidisciplinary ICU care is of paramount importance. With these general concepts in mind, we decided to choose the different topics outlined in this issue of Seminars. Several of the topics presented are controversial but are presented in an unbiased way. Furthermore, our field is very dynamic with constant changes and one of our main goals was to provide the reader with current updated information. In summary, this issue of Seminars will hopefully illustrate the tremendous advances that have been made in the care of the critically ill over the past decade.

We would like to thank all the contributors to this issue of the Seminars for their time, effort, and for sharing their extraordinary expertise, which we hope will enhance your understanding and interest in the field of critical care medicine.