Historical perspectives of critical care in India and worldwide

Abstract

This article highlights and describes the important historical developments in critical care medicine worldwide, including India’s initial journey in this field. The concept of critical care is modern; however, its underlying foundations are profound and have their starting point in the work of Ignaz Semmelweis and Joseph Lister, who laid the foundation for scientific developments in medicine. The routes of critical care can also be found in the contribution of Florence Nightingale in the 1850s during the Crimean War, which included the concept of separate geographical areas for those who were sicker than others. With the emergence of this concept, the establishment of separate post-operative units, the formation of shock wards, the use of artificial airways and mechanical ventilators, the constant evolution of biomedical technology, etc., further led to advancements in critical care medicine. In India, critical care remained focused on cardiac and respiratory care in its initial days but later expanded to involve other unstable patients. The private sector took the lead in establishing separate critical care units, followed by government teaching hospitals. In the current era, critical care medicine represents tremendous growth in the field of biotechnology, innovative communication approaches, the use of multi-disciplinary approach, and essentially the use of evidence-based practices. Furthermore, the emergence of precision medicine has started influencing treatment choices and healthcare decisions to provide more personalized medical care.