The story of critical care in Asia: a narrative review

Journal of Intensive Care

for the Asian Critical Care Clinical Trials Group¹  Jose Emmanuel M. Palo²  Masaji Nishimura³  Aidos Konkayev⁴  Seyed Mohammad Reza Hashemian⁵  Do Ngoc Son⁶  Charles D. Gomersall⁷  Lowell Ling⁷  Jigeeshu Vasishtha Divatia⁸  Mohd Basri Mat-Nor⁹  Gentle Sunder Shrestha^1,10  Moritoki Egi^1,11  Madiha Hashmi^1,12  Rohan Dissanayake^1,13  Chairat Permpikul^1,14  Younsuck Koh^1,15  Chae-Man Lim^1,15  Jason Phua^1,16  Mohammad Omar Faruq^1,17  Yaseen M. Arabi^1,18  Khalid Mahmood Khan Nafees^1,19  Hon Liang Tan^2,20  Boonsong Patjanasoontorn^2,21  Ming-Cheng Chan^2,22  Bin Du^2,23 

[1] ;Acute and Critical Care Institute, The Medical City;Aizenbashi Hospital;Anaesthesiology and Reanimatology Department, Astana Medical University;Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences;Critical Care Unit, Center for Emergency Medicine, Bach Mai Hospital;Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital;Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute;Department of Anaesthesiology and Intensive Care, International Islamic University Malaysia;Department of Anaesthesiology, Tribhuvan University Teaching Hospital;Department of Anesthesiology and Intensive Care Medicine, Kobe University Hospital;Department of Critical Care Medicine, Ziauddin University;Department of Intensive Care Medicine, Gosford Hospital;Department of Medicine, Siriraj Hospital, Mahidol University;Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine;FAST and Chronic Programmes, Alexandra Hospital, National University Health System;General Intensive Care Unit, Emergency and COVID ICU, United Hospital Ltd;King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs;Ministry of Health, Department of Critical Care Medicine, RIPAS Hospital;Mount Elizabeth Novena Hospital;Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University;Section of Critical Care and Respiratory Therapy, Department of Internal Medicine, Taichung Veterans General Hospital;State Key Laboratory of Complex Severe and Rare Diseases, Medical ICU, Peking Union Medical College Hospital;

关键词: Critical care;    Asia;    Intensive care unit;    Epidemiology;    Culture;   

DOI  :  10.1186/s40560-021-00574-4

来源: DOAJ

【 摘 要 】

Abstract Background Asia has more critically ill people than any other part of our planet. The aim of this article is to review the development of critical care as a specialty, critical care societies and education and research, the epidemiology of critical illness as well as epidemics and pandemics, accessibility and cost and quality of critical care, culture and end-of-life care, and future directions for critical care in Asia. Main body Although the first Asian intensive care units (ICUs) surfaced in the 1960s and the 1970s and specialisation started in the 1990s, multiple challenges still exist, including the lack of intensivists, critical care nurses, and respiratory therapists in many countries. This is aggravated by the brain drain of skilled ICU staff to high-income countries. Critical care societies have been integral to the development of the discipline and have increasingly contributed to critical care education, although critical care research is only just starting to take off through collaboration across groups. Sepsis, increasingly aggravated by multidrug resistance, contributes to a significant burden of critical illness, while epidemics and pandemics continue to haunt the continent intermittently. In particular, the coronavirus disease 2019 (COVID-19) has highlighted the central role of critical care in pandemic response. Accessibility to critical care is affected by lack of ICU beds and high costs, and quality of critical care is affected by limited capability for investigations and treatment in low- and middle-income countries. Meanwhile, there are clear cultural differences across countries, with considerable variations in end-of-life care. Demand for critical care will rise across the continent due to ageing populations and rising comorbidity burdens. Even as countries respond by increasing critical care capacity, the critical care community must continue to focus on training for ICU healthcare workers, processes anchored on evidence-based medicine, technology guided by feasibility and impact, research applicable to Asian and local settings, and rallying of governments for support for the specialty. Conclusions Critical care in Asia has progressed through the years, but multiple challenges remain. These challenges should be addressed through a collaborative approach across disciplines, ICUs, hospitals, societies, governments, and countries.

【 授权许可】

Unknown