This paper addresses the design of a generic and scalable platform for the execution of medical decision support agents in the intensive care unit (ICU). As will be motivated, medical decision support agents can impose high computational load and in practical setups a large amount of such agents are typically running in parallel. Future ICU systems will rely on extensive medical decision support. However, in current systems only one workstation is typically dedicated for the execution of medical decision support agents. Therefore, we propose an architecture based on middleware technology to allow for easy distribution of the agents along multiple workstations. The architecture allows for easy integration with a general ICU data flow management architecture.