Intensivisti

Intensivisti, or intensivists, are physicians specialized in intensive care medicine who direct care for critically ill patients in intensive care units (ICUs). They manage multi-organ failure and coordinate life-sustaining therapies such as mechanical ventilation, vasopressor support, renal replacement therapy, and advanced circulatory and respiratory support, including extracorporeal membrane oxygenation (ECMO). They work within multidisciplinary teams and are responsible for prognosis, ethical discussions, and transitions to palliative care when appropriate.

Training typically follows completion of a primary medical specialty (such as internal medicine, anesthesiology, surgery, or pediatrics) and includes a dedicated fellowship in critical care medicine. Certification varies by country; in the United States, clinicians complete a 2- to 3-year critical care fellowship after residency, while European programs integrate intensive care as a specialty. Competencies include invasive procedures, hemodynamic monitoring, infection management, nutrition, rehabilitation, and, increasingly, telemedicine.

Intensivisti work in hospital ICUs, including medical, surgical, and pediatric units, often coordinating care with nurses, pharmacists, respiratory therapists, surgeons, and ethicists. They may participate in regional or tele-ICU networks and contribute to disaster response and clinical research to improve outcomes.

Critical care medicine developed in the mid-20th century alongside advances in ventilation, monitoring, and organ support. Intensivists have played a key role in improving survival for patients with severe illness such as respiratory failure and sepsis, while addressing challenges related to resource use, access, and end-of-life decisions, particularly during pandemics and mass casualty events.