Organ support is key for ICU patients, as one or more organ systems may start to fail.

Respiratory failure may be treated with simple oxygen, non-invasive ventilation, tracheal intubation and mechanical ventilation and in severe cases, Extracorporeal Membrane Oxygenation (ECMO). Cardiovascular failure requires fluid optimization and if required vasoactive medication (vasopressors and inotropes). In specialist centres, mechanical support for the heart may be used, often as a bridge before major surgery or transplantation.

Other organs benefit from basic resuscitation methods (i.e. adequate oxygen delivery and adequate mean arterial pressure), although some specific therapies exist such as renal replacement therapy.

A number of other areas also need to be addressed such as nutrition, thromboprophylaxis and hyperglycaemia. Microbiology is key for early management of sepsis including hospital acquired infections including indwelling central and arterial cannulae.

Good communication is essential for clinical handover, as well as with patients and their next of kin. Finally, occasionally difficult decisions and conversations are required concerning ethics, end of life care and organ donation.