Minimum requirements for the design of Brazilian intensive care units: is it time for a change?

Barreto, Bruna Brandão; Luz, Mariana; Mello, Patrícia Machado Veiga de Carvalho; Gusmao-Flores, Dimitri

doi:10.62675/2965-2774.20260402

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Narrative Review • Crit. Care Sci. 38 • 2026 • https://doi.org/10.62675/2965-2774.20260402 linkcopy

Minimum requirements for the design of Brazilian intensive care units: is it time for a change?

Authorship SCIMAGO INSTITUTIONS RANKINGS

The Brazilian government's minimum requirements for intensive care unit design date back to 2002 and conflict with decades of scientific evidence that emphasize the environment's impact on patient healing and health care professionals’ performance and errors, jeopardizing patient, family member, and intensive care clinician outcomes. Using guidelines from the United States and Indian Society of Critical Care Medicine, the European Society of Intensive Care Medicine and the College of Intensive Care Medicine of Australia and New Zealand as comparators, this review showcase how Brazilian minimum requirements for intensive care unit design misalign with that scientific evidence, laying the groundwork for the development of evidence-based health policies by the national intensive care medicine society and government institutions. Five domains of intensive care unit design were addressed: patient visibility, bedside workspace, lighting, bedroom layout, and greenery and outdoor facilities. Under each domain, evidence is presented indicating that current national standards for intensive care unit design are associated with negative outcomes for patients, family members, and healthcare professionals, such as decreased safety for both patients and healthcare providers, delayed recovery, and increased work-related stress, absenteeism, and human errors. Therefore, updating Brazilian minimum requirements for intensive care unit design is an urgent and necessary step to improve critical care outcomes for patients, family members, and intensive care unit staff.

Keywords:
Intensive care units; Architectural drawing; Healing environment; Middle-income country

Aspect	Brazil*	United States†	Europe†	Oceania§	India¶
Patient visibility	Not addressed	High-visibility	Patients should be visualized at all times (large window opening, glass doors)	High-visibility; direct patient observation from nursing stations	Patient must be easily visible from the charting area
Window and natural light	Not addressed	Yes	Yes	Yes	Yes
Room size	10.0 m² with a distance of 1 m from the lateral walls, except for the head and foot of the bed, which must be at least 1.2 m away from the wall	FGI 2010: minimum 18.6m² with a minimum headwall width 3,96m per bed SCCM 2012: clear area around the standard critical care bed, distancing not less than 1,2m from the head and foot of the bed, and not less than 1,8m on each side (this does not include space needed for staff and family support functions)	Minimum of 25m² for single rooms and 20m² per bed for common rooms, rectangular with at least 2.5m traffic area beyond the bed area	Minimum of 25 m² for single rooms and 20 m² per bed for common rooms	At least 14m² or 18m² for open-bay layout. 18 to 23m² for single bedrooms. The isolation room should have 20% extra space
Nursing station	At least one of the stations (when there is more than one) must have 6.0m²	Centralized or decentralized	Central	Central	Central
Medical prescription room/medical office	1.5m²	1m² to serve every two beds	20m² (medical office)	Yes	Yes
Family interview room/ consultation room	6.0m²	Yes (capacity of not less than 1,5 persons per patient bed)	15 m² room	Yes, with facilities to deal with more than one grieving family	Yes
Kitchen	2.6m² with a minimum dimension of 1.15m	Yes	(in the staff lounge)	Yes	Not addressed
On-call bedrooms	2.6m² with a minimum dimension of 1.15m	Yes	15 m² room with a bed, a hand-basin, a shower, a toilet, a telephone, a television, and access to daylight with an operable window	Yes	Not addressed
Staff lounge	1.3m² per person	Yes (separate from multipurpose/teaching room) - minimum of 9.29m²	A staff lounge of 40 m² for eight intensive care beds	Yes	Yes
Family accommodation	Not addressed	Yes	Yes	Yes	Yes
Teaching / multipurpose room	Not addressed	Yes	40 m² space for formal teaching	Yes	Yes

location_on

Associação de Medicina Intensiva Brasileira - AMIB Rua Arminda, 93 - 7º andar - Vila Olímpia, CEP: 04545-100, Tel.: +55 (11) 5089-2642 - São Paulo - SP - Brazil
E-mail: ccs@amib.org.br

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[TFN1] To further highlight the discrepancies between Brazilian regulations and international recommendations, the table provides a detailed comparison of key aspects of intensive care unit design.

[TFN2] ^*
Resolução da Diretoria Colegiada n° 50/2002;

[TFN3] ^†
SCCM 2024 Guidelines on ICU Design/SCCM Guidelines for intensive care unit design 2012 / FGI 2010; † European Society of Intensive Care Medicine recommendations on basic requirements for intensive care units: structural and organizational aspects 2011;

[TFN4] ^§
College of Intensive Care Medicine of Australia and New Zealand 2016;

[TFN5] ^¶
Indian Society of Critical Care Medicine Experts Committee Consensus Statement on ICU Planning and Designing, 2020. FGI - Facility Guidelines Institute; SCCM - United States Society of Critical Care Medicine.