Major Issues in Critical Care Medicine

In March 1983, a consensus development conference was held at the National Institutes of Health to address issues related to the practice of critical care medicine. This monograph, consisting of 31 chapters written by 40 contributors, was compiled with the ambitious goal of addressing "all of the major issues presently facing the field of Critical Care." The scientific basis and appropriateness of application of the multifaceted technology applicable to the care of critically ill patients are addressed. The organizers asked whether the remarkably rapid expansion of intensive care facilities has been cost redeeming with respect to reduction in morbidity and mortality, the risk of iatrogenic complications, and the high monetary costs of life-saving care.

Their effort to examine the overall results objectively is constructive. At one extreme, previously healthy patients who have attempted suicide by drug overdose have an extraordinarily favorable outlook with intensive care and especially mechanical ventilation. At