Fresenius Medical Care has established critical care as a key pillar for strategic growth. To help realize the company’s long-term vision, the Global Medical Office has created an interdisciplinary critical care therapy team to guide the development new diagnostic tools, advanced data analytics and AI capabilities, innovative devices, and other critical care delivery improvements.

Critical care, or intensive care, is the medical specialty that treats life-threatening conditions, which are often accompanied by organ and/or central nervous system dysfunction. Critical illness necessitates highly complex medical care and may require the need for multi-organ support. The primary goal of critical care is to provide physiologic support while the underlying disease or injury is treated and, in that regard, may be considered by some as “bridging” rather than “healing.”

Despite significant improvements in critical care medicine over the past decades, the number and utilization of critical care beds is still on the rise.¹ Multiple factors may contribute to the observed increase, including aging populations, higher prevalence of coexisting chronic illnesses, broader use of immunosuppressive therapies, higher utilization of medical procedures and devices, and the spread of multi-drug-resistant pathogens. Despite the increasing numbers of critically ill patients, the overall mortality associated with critical illness has declined—e.g., age-standardized sepsis mortality decreased by 52.8 percent from 1990 to 2017.² This may be related to a better understanding of pathophysiology, improvements in ICU management (e.g., acute respiratory distress syndrome protocols, prevention of bloodstream infections), innovations in treatment, and advances in extracorporeal organ support.

CRITICAL CARE: STRATEGIC VISION FOR THE RENAL CARE CONTINUUM

In 2020, Fresenius Medical Care established critical care as one of three strategic pillars for the company’s successful long-term growth (Figure 1). This vision also includes the renal care continuum, the critical care space, and complementary assets — innovations that can advance the company’s work in kidney and critical care. Critical care as a core domain recognizes the importance of multi-organ support as a key component of care for those with critical illness. Today, the Fresenius Medical Care portfolio includes extracorporeal kidney, heart, and lung support. Kidney replacement therapies for acute kidney injury in the ICU include the company’s multiFiltratePRO CRRT device and the NxStage System One. Integration of the Xenios company into the Fresenius Medical Care portfolio in 2016 expanded extracorporeal support to include heart and lung therapies such as extracorporeal membrane oxygenation (ECMO) and decarboxylation (extracorporeal CO2 removal, or ECCO2R) systems. In addition to providing critical care services in selected countries, Fresenius Medical Care also provides a portfolio of critical care products throughout the world (Figure 2).