In the last years we have seen how Intensive Care Medicine has evolved in Spain and we can now affirm that it is possible to do our work in a different way comparing with twenty years ago.

As more current phenomenon, I believe that it has been the emergence of Humanizing Intensive Care Research Project led by Dr. Gabi Heras from Madrid and its extension to the social networks in Facebook and Twitter (@HUMANIZALAUCI). This project has provided the idea of making the ICU more human and closer to the patients and their families. This movement is fashion and in the mouth of most of the professionals who work in intensive care.

Other older factors have also contributed to this favourable evolution in Spanish Intensive Care Medicine, as it is the existence of the Electronic Journal of Intensive Care Medicine (REMI) led by Dr. Eduardo Palencia, with its articles and reviews from journals with high-quality scientific evidence.

Facebook accounts Mechanical ventilation, SEPSIS Forum or OPEN DOOR ICU  are also international references in the transmission of knowledge.

A fact: among all these spaces, more than 40,000 followers.

The concept and methodology of “ICU without walls” of Dr. Federico Gordo of the Hospital Universitario del Henares, with other projects leading to detection of patients at risk in hospital has also contributed to the conceptual change and method in how understanding and doing the critical care.

Recently certain groups are modifying our way of working, trying to analyze flows of critical patients at the territorial level and with the participation of all professionals of the team in the daily decision-making session in a more organized way, as you can see our article recently published in Medicina Intensiva.

Redounding on this critical view of Intensive Care Medicine, numerous scientific articles called ‘negative’ have lately appeared. Negative in the sense that techniques or drugs that are evaluated do not provide benefits to patients, and this fact favors the trend of Medicine withouth treating patients in excess and much more the “Primum non nocere” principle as well as to take care of the final aspects of life; helping and allowing the proximity of family members, and finally, to consider all the professionals who work in the ICU (physicians, nurses, auxiliary, orderlies and administrative), as a team with one main objective: “the caring of invisible”.

I suggest you ‘click’ on all the links and check the bibliography at the end.

Good morning, and good luck! 

Dr. Josep-María Sirvent
ICU of Hospital Universitari de Girona Doctor Josep Trueta


1. Alonso A, Heras G. ICU: a branch of hell? Intensive Care Medicine 2015, Sept 4th.

2. Gordo F, Abella A. Intensive care unit without walls: seeking patient safety by improving the efficiency of the system. Med Intensiva. 2014; 38:438-43.

3. Sirvent JM, Gil M, Alvarez T, Martin S, Vila N, Colomer M, March E, Loma-Osorio P, Metje T. Lean techniques to improve the flow of critically ill patients in a health region with its epicenter in the intensive care unit of a reference hospital. Med Intensiva. 2015 Nov 7.