[SP1-3] Current status of ICU and intensive care medicine in Europe
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Jozef Kesecioglu is Professor of Intensive Care Medicine at the Department of Intensive Care Medicine, University Medical Center, Utrecht, the Netherlands. He completed his medical education and training in anesthesia and intensive care at the Medical School of University of Istanbul, Turkey, where he was later appointed as the head of the intensive care. After moving to the Netherlands in 1989, he worked in Erasmus Medical Center and Sophia Children’s Hospital Rotterdam as anesthetist and pediatric intensivist respectively. He moved to Academic Medical Center in Amsterdam as the deputy director and has become interim director in the same department, before taking up his current position in 2002 in University Medical Center in Utrecht. He has re-organised the four intensive cares and made one department of it before designing and moving to the new, award winning, state-of-the-art ICU. He is currently the chair of the Management Team of the Division of Anesthesiology, Intensive Care and Emergency Medicine.
Professor Kesecioglu was Chairman of the Ethics Section of the European Society of Intensive Care Medicine (ESICM). After finishing his term, he worked in the Executive Committee of ESICM as the elected Chair of the Division of Scientific Affairs. He has also represented ESICM in the workgroup concerning "An official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units". He was elected as President of ESICM in 2016 and served as President Elect until recently. Currently, he is the President of ESICM until the end of his mandate in October 2020.
Professor Kesecioglu has authored around 130 published or in-press peer-reviewed papers and has been giving lectures in various scientific meetings. His main interests are ethics, intensive care environment and selective decontamination of the digestive tract.
Professor Kesecioglu was Chairman of the Ethics Section of the European Society of Intensive Care Medicine (ESICM). After finishing his term, he worked in the Executive Committee of ESICM as the elected Chair of the Division of Scientific Affairs. He has also represented ESICM in the workgroup concerning "An official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units". He was elected as President of ESICM in 2016 and served as President Elect until recently. Currently, he is the President of ESICM until the end of his mandate in October 2020.
Professor Kesecioglu has authored around 130 published or in-press peer-reviewed papers and has been giving lectures in various scientific meetings. His main interests are ethics, intensive care environment and selective decontamination of the digestive tract.
Modern intensive therapy gives the responsibility of patient care and decision-making to specially trained intensivists. Intensive care units are becoming independent medical departments in the organization with allocated budget and staff, committed only to Intensive Care Medicine.Physicians must be trained in order to practice multidisciplinary Intensive Care Medicine. The changes expected in the near future can be summerizef as follows:
• A culture of quality improvement
• Increase in large, multicenter intensive care trials that are not industry funded
• Increased survival
• Ethical discussions
• Expansion of Medium Care facilities
• Patient data management systems (data accessible for audit, research, and quality improvement)
• Precision medicine with individual tailoring of therapies
• Antibiotic resistance and the development MDRO
• Increasing regionalization of ICUs to concentrate expertise in fewer and larger centers.
• Continuing emphasis on quality improvement and doing the simple things well vs expensive new drugs and interventions.
• Aging population
• Increasing expectations from patients, families and doctors from other specialties
• Increase in the illnesses that are deemed treatable
• Steady rise in obesity and other comorbidities
• Demand for ICU care will rise exponentially.
• Efficient use of ICU beds is mandatory.
Therefore, Restriction of ICU admission to those who are likely to benefit most, end-of-life decisions, time limited trials and disclosure of medical errors should be the main issues for the future of intensive care medicine.
• A culture of quality improvement
• Increase in large, multicenter intensive care trials that are not industry funded
• Increased survival
• Ethical discussions
• Expansion of Medium Care facilities
• Patient data management systems (data accessible for audit, research, and quality improvement)
• Precision medicine with individual tailoring of therapies
• Antibiotic resistance and the development MDRO
• Increasing regionalization of ICUs to concentrate expertise in fewer and larger centers.
• Continuing emphasis on quality improvement and doing the simple things well vs expensive new drugs and interventions.
• Aging population
• Increasing expectations from patients, families and doctors from other specialties
• Increase in the illnesses that are deemed treatable
• Steady rise in obesity and other comorbidities
• Demand for ICU care will rise exponentially.
• Efficient use of ICU beds is mandatory.
Therefore, Restriction of ICU admission to those who are likely to benefit most, end-of-life decisions, time limited trials and disclosure of medical errors should be the main issues for the future of intensive care medicine.