Advances in intensive care medicine greatly improved survival rates following critical illness. However, the long-term consequences of these life-saving interventions were generally overlooked, only coming to light in recent years through large prospective studies and systematic analysis of data registers.

Survivors of intensive therapy often suffer from significant limitations. Cognitive disorders, loss of mobility, and psychiatric disorders are among the serious, and sometimes permanent, consequences of intensive care. It is not uncommon that patients remain dependent on organ replacement procedures, such as long-term ventilation. This complex of functional limitations is today collectively known as "Post-Intensive Care Syndrome" (PICS), while the need for longterm application of intensive care measures is labeled "Chronic Critical Illness (CCI)". CCI in particular involves long-term stays in intensive care facilities, which often lead to disability.

Germany has a higher density of intensive care beds than any other country, thus proportionally also a greater responsibility in the prevention of long-term consequences associated with intensive care. Aside from mortality, clinical studies are increasingly focusing on functional outcome, so as to evaluate the actual benefits of new interventions more accurately and transparently. In clinical routine, a prescient treatment of patients in respect to the preservation of cognition and mobility is seen as a hallmark of quality in intensive care. This was taken into consideration in the establishment of guidelines, e.g. concerning analgesia, sedation and delirium management, as it was declared by the German Interdisciplinary Association for Intensive and Emergency Medicine (DIVI) as a national quality indicator for intensive care medicine.

The realignment of the intensive care medicine poses new scientific, social, and economic challenges. New strategies will be discussed with international experts at the Leopoldina Symposium "The Evolution of Intensive Care", with the ultimate goal of improving the well-being of our patients.


Univ.-Prof. Dr. Claudia Spies
Department for Anesthesiology and Intensive Care Medicine
CCM and CVK, Charité – Universitätsmedizin Berlin
Augustenburger Platz 1
13353 Berlin

t: +49 30 450 551 032



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