Intensive care of the future: in 10 points

Abstract

We consider 10 areas in which intensive care will have changed in the future. We can choose between centralizing seriously ill patients in reference institutions or keeping them in local units using telemedicine supervision. There is a better continuum between the different places where a patient can be, from home to emergency room to intensive care,…. Monitoring in hospital wards is automated, with small, non-invasive and non-restrictive devices. Treatment is also largely automated. Organ support is essentially non-invasive, but extracorporeal devices are nevertheless widely used. Pain is better controlled, but sedative use has almost disappeared. Patients are mobilized early and taken outdoors as soon as possible. Strategies to distract patients are provided and the presence of pets authorized. The automation of monitoring and treatment has reduced the need for staff for these purposes, who are therefore more available to talk to patients and families, who are much more present on the unit. Ethical decisions are facilitated by a better assessment of patient prognosis and a better understanding by society of end-of-life issues. Clinical studies have also evolved, thanks to a better selection of patients and the analysis of large databases.