New frontiers in critical care medicine.

Critical care medicine integrates various treatment modalities to provide care of patients with multiple system dysfunction or failure and to determine the diagnosis of the particular condition. The pulmonary artery catheter advanced from a simple tool to measure intracardiac pressures and output to methodology enabling clinicians to understand the balance between oxygen delivery and utilization. Critical care developed new concepts in the treatment of respiratory failure including not only forms of mechanical ventilation such as pressure control but also methods such as ECMO and surfactant therapy which may preclude the need for mechanical ventilation or minimize its needs. Sepsis represents the greatest problem in caring for the critically ill. Continued development of genetically engineered drugs may ultimately improve survival and reduce complications. Critical care has become a subspecialty, synthesizing the basic knowledge from anesthesiology, internal medicine, pediatrics and surgery. Its multidisciplinary delivery represents the way of the future.