Gallagher T J
Department of Anesthesiology, University of Florida College of Medicine, Gainesville.
J Fla Med Assoc. 1993 Oct;80(10):689-92.
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.
重症医学整合了各种治疗方式，以照顾多系统功能障碍或衰竭的患者，并确定特定病症的诊断。肺动脉导管从一种简单的测量心内压力和输出量的工具发展成为一种方法，使临床医生能够了解氧输送和利用之间的平衡。重症医学在呼吸衰竭的治疗方面提出了新的概念，不仅包括诸如压力控制等机械通气形式，还包括如体外膜肺氧合（ECMO）和表面活性剂疗法等方法，这些方法可能避免机械通气的需要或尽量减少其需求。脓毒症是重症患者护理中最大的问题。基因工程药物的不断发展最终可能提高生存率并减少并发症。重症医学已成为一个亚专业，综合了麻醉学、内科、儿科学和外科学的基础知识。其多学科的服务代表了未来的发展方向。
