High quality research evidence is now available to guide and shape the practice of critical care. As the generation of such evidence increases, the challenge facing critical care medicine will be translation of this evidence into measurable improvement in patient outcome. Significant barriers to this process of translation exist that will require substantial effort and resources to overcome. We briefly review the nature of translational barriers to incorporation of research evidence into clinical practice and the conventional approach to surmounting these barriers, and provide examples of barriers and potential solutions to emerging therapies in critical care.