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Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Mar 9, 2024; 13(1): 90176
Published online Mar 9, 2024. doi: 10.5492/wjccm.v13.i1.90176
21st century critical care medicine: An overview
Smitesh Padte, Vikramaditya Samala Venkata, Priyal Mehta, Sawsan Tawfeeq, Rahul Kashyap, Salim Surani
Smitesh Padte, Priyal Mehta, Sawsan Tawfeeq, Rahul Kashyap, Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
Vikramaditya Samala Venkata, Department of Hospital Medicine, Cheshire Medical Center/Dartmouth Health, Keene, NH 03431, United States
Rahul Kashyap, Department of Research, WellSpan Health, York, PA 17403, United States
Rahul Kashyap, Salim Surani, Department of Pulmonary & Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
Salim Surani, Department of Medicine & Pharmacology, Texas A&M University, College Station, TX 77843, United States
Author contributions: Padte S, Kashyap R, and Surani S contributed to the study conceptualization and methodology; all co-authors contributed to data acquisition; the original draft was prepared by Padte S, Venkata VS, Mehta P, Tawfeeq S, and Kashyap R, and Surani S have supervised and final edited the manuscript; All listed co-authors authors provided intellectual contributions and made critical revisions to this paper; All authors approved the final version of the manuscript.
Conflict-of-interest statement: None of the authors have any conflict of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Salim Surani, FCCP, MD, Professor, Department of Medicine & Pharmacology, Texas A&M University, 40 Bizzell Street, College Station, TX 77843, United States. srsurani@hotmail.com
Received: November 26, 2023
Peer-review started: November 26, 2023
First decision: December 23, 2023
Revised: December 28, 2023
Accepted: January 24, 2024
Article in press: January 24, 2024
Published online: March 9, 2024
Processing time: 100 Days and 4.2 Hours
Abstract

Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units (ICUs). This abstract provides a concise summary of the latest developments in critical care, highlighting key areas of innovation. Recent advancements in critical care include Precision Medicine: Tailoring treatments based on individual patient characteristics, genomics, and biomarkers to enhance the effectiveness of therapies. The objective is to describe the recent advancements in Critical Care Medicine. Telemedicine: The integration of telehealth technologies for remote patient monitoring and consultation, facilitating timely interventions. Artificial intelligence (AI): AI-driven tools for early disease detection, predictive analytics, and treatment optimization, enhancing clinical decision-making. Organ Support: Advanced life support systems, such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ support. Infection Control: Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated infections. Ventilation Strategies: Precision ventilation modes and lung-protective strategies to minimize ventilator-induced lung injury. Sepsis Management: Early recognition and aggressive management of sepsis with tailored interventions. Patient-Centered Care: A shift towards patient-centered care focusing on psychological and emotional well-being in addition to medical needs. We conducted a thorough literature search on PubMed, EMBASE, and Scopus using our tailored strategy, incorporating keywords such as critical care, telemedicine, and sepsis management. A total of 125 articles meeting our criteria were included for qualitative synthesis. To ensure reliability, we focused only on articles published in the English language within the last two decades, excluding animal studies, in vitro/molecular studies, and non-original data like editorials, letters, protocols, and conference abstracts. These advancements reflect a dynamic landscape in critical care medicine, where technology, research, and patient-centered approaches converge to improve the quality of care and save lives in ICUs. The future of critical care promises even more innovative solutions to meet the evolving challenges of modern medicine.

Keywords: Critical care medicine; Intensive care unit; Precision medicine; Telemedicine; Artificial intelligence; Organ support; Sepsis; Infection control; Patient-centered care

Core Tip: In 1959, the first modern critical care unit, led by Dr. Peter Safar, emerged at the University of Pittsburgh, as detailed in the American Thoracic Society Journal. Critical care medicine has since expanded from traditional hospital settings to include emergency departments, ambulances, and even aircraft. The advent of the 21st century has ushered in notable advancements, including enhanced ventilation and organ support systems such as extra-corporeal membrane oxygenations, or even integrating telemedicine to extend critical care expertise to remote regions. In this dynamic environment, staying abreast of innovations such as artificial intelligence, precision medicine, nanotechnology in sepsis management, and inventive infection control strategies is crucial for reshaping our intensive care units. Our goal, amid these advances, is to provide a comprehensive overview of 21st-century progress in critical care, offering succinct insights on various specific topics in critical care medicine.