Section V - Critical Case Medicine
Chapter 74
- Overview of Anesthesiology and Critical Care Medicine
- Linda Liu
- Michael A. Gropper
The practice of critical care medicine, which originated in the
1940s with anesthesiologists providing life support to patients with polio, has undergone
revolutionary changes. The development of equipment, procedures, and medications
has enabled intensivists to treat critically ill patients and support them through
increasingly invasive procedures. In the past decade, another revolution has taken
place, with the introduction of evidence-based medicine into intensive care unit
(ICU) practice.
In this chapter, we discuss the structure and staffing of ICUs,
including studies examining the value of intensivist staffing. We then review how
intensivist staffing may lead to improved outcomes, specifically through the implementation
of evidence-based practice. Particular attention is paid to implementation and cost-effectiveness
of new clinical practices. Cost-effective care in the ICU is of increasing economic
importance, because approximately 1% of the gross domestic product of the United
States is consumed caring for patients in ICUs.[1]
