CCM, a well-established specialty focused on the diagnosis, monitoring, and treatment of life-threatening conditions, serves as a cornerstone of modern hospital systems. Its capacity not only reflect the ability to treat the most severely ill patients but also a nation's preparedness for public health emergencies. In China, CCM has developed rapidly over the past four decades, shaped by healthcare reforms and stress-tested by major crises such as the severe acute respiratory syndrome (SARS) outbreak, natural disasters, and the COVID-19 pandemic. While these crises highlighted substantial progress, they also exposed structural gaps and regional disparities, underscoring the need for standardized national guidance.
To address these challenges, the Chinese Society of Critical Care Medicine convened a multidisciplinary panel of experts to develop updated guidelines for CCM in China. The guidelines were available in the Journal of Intensive Medicine on December 30, 2025. The initiative was led by senior intensivists, including Professor Dechang Chen of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; Professor Yan Kang of West China Hospital, Sichuan University; and Professor Xiangdong Guan of the First Affiliated Hospital of Sun Yat-sen University. The guideline was formulated through a structured, evidence-based consensus process that systematically reviewed national policies, international standards, and data from China's expanding intensive care network. Recommendations were refined through multiple rounds of expert discussion and anonymous voting using a modified Delphi method, ensuring both scientific rigor and practical applicability across hospitals with varying levels of resources.
A central focus of the guideline is ICU infrastructure planning. Clear recommendations are provided for ICU bed proportions in secondary and tertiary hospitals, spatial layout, infection prevention design, and essential equipment configuration. Notably, the guideline introduces the concept of routine-emergency integration, enabling general wards to be rapidly converted into functional ICUs within 24 hours during public health emergencies. The establishment of independent sub-ICU units and step-down wards is also emphasized to improve patient flow and manage surge capacity, and ensure continuity of care.
Workforce development represents another core component. The guideline defines standardized staffing ratios, competency requirements, and training pathways for intensivists, nurses, respiratory therapists, and rehabilitation specialists. It promotes structured residency and subspecialty training programs, standardized certification systems, and the development of high-level clinical leaders capable of advancing clinical care, education, and research.
"High-quality critical care depends not only on advanced equipment, but on well-trained multidisciplinary teams working within standardized systems," says Professor Dechang Chen. "These guidelines aim to reduce disparities in care and ensure that critically ill patients receive consistent, evidence-based treatment nationwide."
Technology integration is also major theme. The guideline calls for the establishment of intelligent critical care information management systems that integrate electronic medical records, real-time patient monitoring, and clinical decision-support tools. These systems, along with the application of artificial intelligence and deep learning, are expected to enhance early warning, precision treatment, and quality control, while simultaneously enabling data-driven research and continuous quality improvement.
Emergency preparedness is addressed comprehensively. The guideline outlines scalable ICU service models, flexible emergency staffing mechanisms, and the implementation of regular preparedness drills. It also highlights the role of regional telemedicine networks, which allow experienced centers to provide real-time remote guidance and support to hospitals in resource-limited areas during crises.
"By strengthening digital connectivity and regional collaboration, critical care expertise can reach far beyond individual hospitals," says Professor Yan Kang. "This approach is essential for improving outcomes during public health emergencies."
Beyond acute life support, the guideline emphasizes early rehabilitation, multidisciplinary collaboration, and coordinated referral systems to support long-term recovery after critical illness. These measures aim to reduce complications, shorten hospital stays, and improve post-ICU quality of life.
In summary, the 2025 national guidelines represent a comprehensive framework for advancing CCM in China. By standardizing infrastructure, workforce development, technology integration, and emergency response, the guidelines lay the foundation for more equitable, resilient, and high-quality critical care system capable of meeting both routine clinical needs and future public health challenges.
