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The story of critical care in Asia: a narrative review

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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.
Author(s)
고윤석임채만Aidos KonkayevAsian Critical Care Clinical TBin DuBoonsong PatjanasoontornChairat PermpikulCharles D GomersallDo Ngoc SonGentle Sunder ShresthaHon Liang TanJason PhuaJigeeshu Vasishtha DivatiaJose Emmanuel M PaloKhalid Mahmood Khan NafeesLowell LingMadiha HashmiMasaji Ni
Issued Date
2021
Type
Article
Keyword
AsiaCritical careCultureEpidemiologyIntensive care unit
DOI
10.1186/s40560-021-00574-4
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7178
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_ca35431a2777460b801aad9113ae9c1c&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,The%20story%20of%20critical%20care%20in%20Asia:%20a%20narrative%20review&offset=0&pcAvailability=true
Publisher
Journal of Intensive Care
Location
영국
Language
영어
ISSN
2052-0492
Citation Volume
9
Citation Number
1
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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