The development of the specialty of critical care and the intensivist is outlined and the data that favours critically ill patients being cared for by intensivists are reviewed. The future challenges for intensive and critical care are dealing with the new ethical dilemmas raised by intensive care, providing appropriate intensive care in both developed and developing countries and applying the principles of evidence-based medicine to intensive therapy.
Although special areas for postoperative patients existed 50 years ago, the modern specialty of Critical Care began during the polio epidemic of the 1950s. Prolonged hand ventilation, and positive or negative pressure ventilation, enabled maintenance of oxygenation until some patients developed sufficient recovery or compensatory processes to enable separation from artificial ventilation or continued survival on permanent or intermittent ventilation.
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