The story of critical care in Asia: a narrative review

Phua, Jason and Lim, Chae Man and Faruq, Mohammad Omar and Nafees, Khalid and Du, Bin and Gomersall, Charles and Ling, Lowell and Divatia, Jigeeshu Vasishtha and Hashemian, Seyed and Egi, Moritoki and Konkayev, Aidos and Mat Nor, Mohd Basri and Shrestha, Gentle Sunder and Hashmi, Madiha and Palo, Jose Emmanuel and Arabi, Yaseen M and Tan, Hon Liang and Dissanayake, Rohan and Chan, Ming Cheng and Permpikul, Chairrat and Patjanasoontorn, Boonsong and Son, Do Ngoc and Nishimura, Masaji and Koh, Younsuck (2021) The story of critical care in Asia: a narrative review. Journal of Intensive Care, 9 (1). pp. 1-12. ISSN 2052-0492

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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.

Item Type:	Article (Review)
Uncontrolled Keywords:	Critical care, Asia, Intensive care unit, Epidemiology, Culture
Subjects:	R Medicine > R Medicine (General) R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Depositing User:	Dr. Mohd Basri Mat Nor
Date Deposited:	01 Mar 2022 09:13
Last Modified:	01 Mar 2022 09:13
URI:	http://irep.iium.edu.my/id/eprint/96421

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