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Critical Care Medicine The Past and Changes in the Future

Roger C. Bone, MD
JAMA. 1984;252(15):2060-2061. doi:10.1001/jama.1984.03350150060024.
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Most recent innovations in medical sciences arose as a response to specific clinical problems. Examples include antibiotics for previously lethal pneumonia and tuberculosis. Intensive care had no such origins. The intensive care unit grew out of technological advances of the last decade. Physicians were presented with an enormous array of capabilities. In addition to the stethoscope and roentgenogram the physician could examine hemodynamics, expired air, gas contents, and respiratory physiological measurements. With previously lethal respiratory disease, the physician could intubate, ventilate, and resuscitate. An exciting new potential existed for patient care. Objective information could be obtained in real time and a trend analysis could be done. A physiological description of disease was possible that never before existed. But because intensive care medicine did not arise to fulfill a specific clinical need, such as penicillin for pneumococcal pneumonia, conditions that would clearly require the application of this advance were neither predetermined


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