Worldwide demand for critical care.

Adhikari, Neill K J; Rubenfeld, Gordon D

PURPOSE OF REVIEW Interest in the global burden of critical illness is growing, but comprehensive data to describe this burden and the resources available to provide care for critically ill patients are lacking. RECENT FINDINGS Challenges to obtaining population-based global estimates of critical illness and resources to treat it include the syndrome-based definitions of critical illness, incorrect equating of 'critical illness' with 'admission to an intensive care unit', lack of reliable case ascertainment in administrative data, and short prodrome and high mortality of critical illness, limiting the number of prevalent cases. Modeling techniques will be required to estimate the burden of critical illness and disparities in access to critical care using existing data sources. Demand for critical care is likely to increase, related to urbanization, an aging demographic, and the ongoing wars, disasters, and pandemics, whereas economic crises will likely decrease the ability to pay for it. SUMMARY Major unexplored research and public health questions remain unanswered regarding the worldwide burden of critical illness, variation in resources available for treatment, and strategies to prevent and treat critical illness that are broadly effective and feasible.