Vincent Jean-Louis, Fink Mitchell P, Marini John J, Pinsky Michael R, Sibbald William J, Singer Mervyn, Suter Peter M, Cook Deborah, Pepe Paul E, Evans Timothy
Department of Intensive Care Medicine, Erasme University Hospital, Route de Lennik 808, 1070 Brussels, Belgium.
Chest. 2006 Apr;129(4):1061-7. doi: 10.1378/chest.129.4.1061.
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.
在过去的四分之一世纪里，重症监护医学已发展成为一门成熟的医院专科，拥有其独特的身份和特征。取得了重大进展，大多是一系列小步骤的积累，而非任何巨大的飞跃，其中许多进展与其他学科医疗保健的进步相关联。此外，许多变化源于对某些曾被认为具有治疗作用的传统做法的有害影响进行科学识别。在此，为了从过去吸取经验并为未来的进步提供指导，我们详细阐述重症监护医学各个方面的一些关键变化，包括呼吸、心血管、代谢和营养护理，以及脓毒症、多发伤、组织和管理。
