Multiple organ failure – often termed the "No.1 killer" in critical care medicine – claims countless lives worldwide each year. Characterized by sudden onset, rapid progression and challenging treatment, it has become a major challenge for healthcare systems across the globe.

Statistics show that mortality rates from multiple organ failure caused by severe sepsis range from 30 percent to as high as 100 percent, and disability rates from 30 percent to 40 percent. Healthcare systems across nations face similar treatment bottlenecks: how to identify high-risk patients early, how to coordinate multi-organ therapies, and how to achieve optimal outcomes within limited resources.

As a country with a large population, China faces particularly intense pressure brought by significant disparities in treatment capabilities between primary hospitals and top-tier medical centers. In response to the global challenge, China's critical care community has forged a distinctive path through practical exploration.

From "solo operations" to multi-disciplinary integration

Traditional critical care often focused on treating individual organs in isolation. However, the core challenge of multiple organ failure lies in the systemic imbalance of the entire body. "To overcome the challenges of multiple organ failure, we need collaborative understanding and technological innovation that transcends departmental, institutional and even national boundaries," says Dr. Huang Man, director of the Comprehensive ICU at the Second Affiliated Hospital of Zhejiang University School of Medicine. With over two decades of experience in critical care medicine, she is acutely aware that isolated efforts are insufficient to tackle this systemic, whole-body disease.

"Deteriorating liver function can affect the coagulation system, thereby increasing the risk of cerebral hemorrhage, while renal insufficiency may limit the use of certain medications," explains Dr. Huang. "Only by viewing the human body as a whole can we grasp the key to effective treatment."

From reactive response to proactive early warning 

The condition of critically ill patients can change hourly and any delay may lead to irreversible outcomes. The team at the Second Affiliated Hospital of Zhejiang University School of Medicine has developed China's first intelligent early warning model for multiple organ failure, whose accuracy rate is as high as 86 percent. This model integrates critical care data from several major hospitals in China, continuously monitoring over a hundred parameters – including vital signs and laboratory indicators – to predict the risk of clinical deterioration in advance. Once the system triggers an alert, doctors can intervene within the "golden time window," significantly reducing mortality rates. As one ICU physician described the shift brought by the early warning system, "In the past, we were running after the disease to rein in it. Now, we set up a defense line before it worsens."

From import dependence to independent innovation 

Extracorporeal membrane oxygenation (ECMO), known as the "ultimate weapon" in critical care, can temporarily replace a patient's heart and lung functions. For a long time, however, the technology was monopolized by foreign companies, leading to high costs and unstable supply in China. Dr. Huang's team took the lead in advancing the R&D of domestically produced ECMO and obtained patents. From the approval of the first-generation products to the upgraded second generation, China has evolved from a follower to a front-runner in this field. Domestic ECMO is not only more affordable but also ensures a more stable supply, allowing more patients to have access to this life-saving technology. "Having core technology under our own control means we can provide treatment with greater confidence," says Dr. Huang. "It also represents our contribution to global equity in critical care."

Common pathways and differentiated approaches in critical care medicine 

Can China's experience offer a reference for other countries? The answer is yes, but it must be adapted to local conditions. In China, with its vast territory, the uneven distribution of medical resources is a significant challenge. At the hospital, with the help of a remote ICU system that allows real-time transmission of patient data, experts can guide treatments in primary hospitals from afar. This system already covers remote regions in western China such as Xinjiang, Gansu, Guizhou and Yunnan. Through the Mountain-Sea Collaboration Project of Zhejiang Province, high-quality medical resources are being extended to county-level hospitals.

In the spring of 2024, Dr. Huang brought her team to Uzbekistan to share expertise in peri-transplant critical care management with local hospitals. The trip marked the move of China's ICU expertise onto the global stage.

"When we were in Uzbekistan, we developed a tiered treatment plan based on local medical conditions and staffing," shares Dr. Huang, reflecting on international collaboration. "The goal was not to simply replicate the Chinese model, but to help establish a critical care system suited to the local reality."

Developed and developing nations face distinct challenges in critical care. While the former possess advanced equipment but struggle with high costs, the latter have limited resources yet urgent needs. Dr. Huang believes that "tiered treatment and targeted empowerment" represent a viable approach to global cooperation – establishing different levels of critical care centers based on regional capacities and increasing overall standards through technical training and remote guidance.

From treatment to prevention: The shared mission of global critical care medicine 

The future of critical care medicine lies not only in better treatment but also in earlier prevention. The integration of disciplines is now paving new paths: artificial intelligence aids in early warning, regenerative medicine explores organ repair and foundational research unravels the nature of disease. Meanwhile, the global shortage of critical care professionals requires urgent attention. China has trained a growing cohort of critical care specialists through systematic training frameworks, including standardized residency programs and specialized physician training. Dr. Huang advocates for the establishment of a global collaborative network for continuing education in critical care that aims to enhance treatment capabilities of developing countries by utilizing online courses and international rotations.

Beyond technology, compassionate care remains the bedrock of critical care medicine. Heartwarming stories such as "A Golden Wedding in the ICU" and "The Sound of Music in the ICU" continue to unfold. Medical staff are deeply aware that they are treating not just "cases," but people with unique life stories. 

"There may be borders for technology to cross, but reverence for life is universal," says Dr. Huang. "In the ICU, we see families from different cultural backgrounds sharing similar worries and hopes."

（All photos are provided by Second Affiliated Hospital of Zhejiang University School of Medicine.）