Special article
The future of intensive care medicine
El futuro de la medicina intensiva
L. Blancha,b,c,
, D. Annaned, M. Antonellie, J.D. Chichef, J. Cuñatg, T.D. Girardh,i, E.J. Jiménezj, M. Quintelk, S. Ugartel, J. Mancebom
Corresponding author
a Critical Care Center, Hospital de Sabadell, Corporacio Sanitaria Universitària Parc Taulí, Sabadell, Spain
b Universitat Autònoma de Barcelona, Spain
c CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
d General ICU, Raymond Poincaré Hospital, AP-HP, University of Versailles SQ, France
e Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
f Réanimation Médicale & Dept de Biologie Cellulaire Hopital COCHIN & Institut Cochin 27 rue du Faubourg Saint-Jacques, Paris, France
g Department of Intensive Care Medicine, Hospital La Fe, Valencia, Spain
h Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, United States
i Geriatric Research, Education and Clinical Center Service, Department of Veterans Affairs Medical Center, Nashville, TN, United States
j University of Florida, University of Central Florida and Florida State University, Orlando, FL, United States
k Department of Anaesthesia and Intensive Care Medicine, University of Göttingen, Göttingen, Germany
l INDISA Clinic and Salvador's Hospital, University Andrés Bello, Santiago de Chile, Chile
m Department of Intensive Care Medicine, Hospital de Sant Pau, Barcelona, Spain
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The organisation of intensive care in multiple specialty or central units is heterogeneous and evolving, but appropriate early treatment and access to a trained inten- sivist should be assured at all times, and intensivists should play a pivotal role in ensuring communication and high-quality care across hospital departments. Structures now exist to sup- port clinical research in intensive care medicine, which should become part of routine patient management. However, more translational research is urgently needed to identify areas that show clinical promise and to apply research principles to the real-life clinical setting. Like- wise, electronic networks can be used to share expertise and support research. Individuals, physicians and policy makers need to allow for individual choices and priorities in the manage- ment of critically ill patients while remaining within the limits of economic reality. Professional scientific societies play a pivotal role in supporting the establishment of a defined minimum level of intensive health care and in ensuring standardised levels of training and patient care by promoting interaction between physicians and policy makers. The perception of intensive care medicine among the general public could be improved by concerted efforts to increase awareness of the services provided and of the successes achieved.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La formación en medicina intensiva, ya sea como especialidad primaria o a partir de una troncalidad común para después convertirse en supra-especialidad, debería incluir compe- tencias clave que garanticen un cuidado estándar y homogéneo del paciente crítico, así como proveer al sistema sanitario del número de especialistas en medicina intensiva (intensivistas) de forma ajustada y anticipada al ritmo de crecimiento de la necesidad asistencial.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La organización de los cuidados intensivos desde la visión de las distintas especialidades o en unidades centralizadas y jerarquizadas, es heterogénea y está en constante evolución. No obstante el acceso y tratamiento precoz del enfermo crítico por parte de un intensivista, debería estar siempre garantizado, no únicamente en los servicios de medicina intensiva, sino en todos los departamentos de un hospital, actuando el intensivista como elemento central en la comunicación y coordinación entre los diferentes servicios y especialistas, a fin de lograr la más alta calidad y eficacia en la asistencia.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La investigación clínica en medicina intensiva está sustentada por la excelencia de conocimiento de sus profesionales, pero son necesarias estructuras de apoyo: la integración de la investigación e innovación en la rutina diaria y un incremento de la investigación trasla- cional, a fin de identificar áreas que muestren elementos potenciales de avance en el aspecto clínico y la aplicación de los principios de la investigación básica y fisiológica en el entorno de la medicina intensiva. Las tecnologías de la comunicación y la información ofrecen un marco idóneo para compartir y poner en común el conocimiento y apoyar la formación, la investigación y la innovación en medicina intensiva.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Ciudadanía, profesionales de la salud y responsables políticos deben apoyar que aquellos profesionales con el mejor conocimiento científico tomen las decisiones sobre las prioridades en la gestión del cuidado del enfermo crítico, dentro de un modelo económico sostenible. Las sociedades científicas tienen un papel crucial en la definición de los niveles mínimos de atención médica intensiva y también en asegurar estándares de capacitación, formación de intensivistas y acreditación, promoviendo la interacción entre especialidades, familias, sociedad y respon- sables políticos. La percepción del valour de la medicina intensiva entre la ciudadanía y la Administración debe ser constantemente mejorada mediante esfuerzos coordinados y dirigidos a incrementar el conocimiento que la medicina intensiva pone a su disposición y de los éxitos alcanzados por esta especialidad.</p>" ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000003700000002/v3_201306280954/S2173572713000325/v3_201306280954/en/main.assets" "Apartado" => array:4 [ "identificador" => "409" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Special article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000003700000002/v3_201306280954/S2173572713000325/v3_201306280954/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572713000325?idApp=WMIE" ]
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| 2022 February | 59 | 53 | 112 |
| 2022 January | 60 | 49 | 109 |
| 2021 December | 52 | 74 | 126 |
| 2021 November | 80 | 56 | 136 |
| 2021 October | 91 | 99 | 190 |
| 2021 September | 56 | 54 | 110 |
| 2021 August | 22 | 52 | 74 |
| 2021 July | 27 | 46 | 73 |
| 2021 June | 21 | 35 | 56 |
| 2021 May | 28 | 52 | 80 |
| 2021 April | 59 | 69 | 128 |
| 2021 March | 50 | 38 | 88 |
| 2021 February | 48 | 23 | 71 |
| 2021 January | 43 | 38 | 81 |
| 2020 December | 20 | 27 | 47 |
| 2020 November | 20 | 24 | 44 |
| 2020 October | 22 | 32 | 54 |
| 2020 September | 34 | 13 | 47 |
| 2020 August | 20 | 18 | 38 |
| 2020 July | 21 | 20 | 41 |
| 2020 June | 16 | 14 | 30 |
| 2020 May | 24 | 22 | 46 |
| 2020 April | 17 | 17 | 34 |
| 2020 March | 13 | 14 | 27 |
| 2020 February | 28 | 31 | 59 |
| 2020 January | 22 | 29 | 51 |
| 2019 December | 26 | 28 | 54 |
| 2019 November | 29 | 26 | 55 |
| 2019 October | 19 | 21 | 40 |
| 2019 September | 27 | 38 | 65 |
| 2019 August | 40 | 21 | 61 |
| 2019 July | 24 | 20 | 44 |
| 2019 June | 32 | 18 | 50 |
| 2019 May | 39 | 24 | 63 |
| 2019 April | 17 | 19 | 36 |
| 2019 March | 21 | 24 | 45 |
| 2019 February | 19 | 45 | 64 |
| 2019 January | 26 | 23 | 49 |
| 2018 December | 18 | 27 | 45 |
| 2018 November | 39 | 49 | 88 |
| 2018 October | 74 | 35 | 109 |
| 2018 September | 38 | 24 | 62 |
| 2018 August | 15 | 18 | 33 |
| 2018 July | 22 | 22 | 44 |
| 2018 June | 22 | 19 | 41 |
| 2018 May | 23 | 9 | 32 |
| 2018 April | 31 | 22 | 53 |
| 2018 March | 17 | 15 | 32 |
| 2018 February | 10 | 9 | 19 |
| 2018 January | 30 | 18 | 48 |
| 2017 December | 10 | 10 | 20 |
| 2017 November | 12 | 14 | 26 |
| 2017 October | 9 | 13 | 22 |
| 2017 September | 14 | 17 | 31 |
| 2017 August | 16 | 12 | 28 |
| 2017 July | 24 | 15 | 39 |
| 2017 June | 24 | 21 | 45 |
| 2017 May | 18 | 9 | 27 |
| 2017 April | 32 | 14 | 46 |
| 2017 March | 14 | 16 | 30 |
| 2017 February | 6 | 13 | 19 |
| 2017 January | 16 | 9 | 25 |
| 2016 December | 10 | 9 | 19 |
| 2016 November | 17 | 14 | 31 |
| 2016 October | 14 | 20 | 34 |
| 2016 September | 17 | 10 | 27 |
| 2016 August | 21 | 8 | 29 |
| 2016 July | 11 | 4 | 15 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2013 August | 1 | 0 | 1 |
| 2013 July | 5 | 0 | 5 |
Show all
