Current Challenges in the Management of Sepsis in ICUs in Resource-Poor Settings and Suggestions for the Future View Full Text


Ontology type: schema:Chapter      Open Access: True


Chapter Info

DATE

2019-02-09

AUTHORS

Marcus J. Schultz , Martin W. Dünser , Arjen M. Dondorp , Neill K. J. Adhikari , Shivakumar Iyer , Arthur Kwizera , Yoel Lubell , Alfred Papali , Luigi Pisani , Elisabeth D. Riviello , Derek C. Angus , Luciano C. Azevedo , Timothy Baker , Janet V. Diaz , Emir Festic , Rashan Haniffa , Randeep Jawa , Shevin T. Jacob , Niranjan Kissoon , Rakesh Lodha , Ignacio Martin-Loeches , Ganbold Lundeg , David Misango , Mervyn Mer , Sanjib Mohanty , Srinivas Murthy , Ndidiamaka Musa , Jane Nakibuuka , Ary Serpa Neto , NT Hoang Mai , Binh Nguyen Thien , Rajyabardhan Pattnaik , Jason Phua , Jacobus Preller , Pedro Povoa , Suchitra Ranjit , Daniel Talmor , Jonarthan Thevanayagam , C. Louise Thwaites

ABSTRACT

Sepsis is a major cause of critical illness worldwide, especially in resource-poor settings. Intensive care units (ICUs) in low- and middle-income countries (LMICs) face many challenges that could affect patient outcome. The aim of this review is to describe differences between resource-poor and resource-rich settings regarding the epidemiology, pathophysiology, economics, and research aspects of sepsis. We restricted this manuscript to the ICU setting although we are aware that many sepsis patients in LMICs are treated outside an ICU. Although many bacterial pathogens causing sepsis in LMICs are similar to those in high-income countries, resistance patterns to antimicrobial drugs can be very different; in addition, causes of sepsis in LMICs often include tropical diseases in which direct damaging effects of pathogens and their products can be more important than the host response. There are differences in ICU capacities around the world; not surprisingly the lowest capacities are found in LMICs with important heterogeneity within individual LMICs. Although many aspects of sepsis management developed in resource-rich countries are applicable in LMICs, implementation requires strong consideration of cost implications and important differences in resources. Addressing both disease-specific and setting-specific factors is important to improve performance of ICUs in LMICs. Although critical care for sepsis is likely cost-effective in LMIC setting, more detailed evaluation at both a macro- and micro-economy level is necessary. Sepsis management in resource-limited settings is a largely unexplored frontier with important opportunities for research, training, and other initiatives for improvement. More... »

PAGES

1-24

Book

TITLE

Sepsis Management in Resource-limited Settings

ISBN

978-3-030-03142-8
978-3-030-03143-5

Author Affiliations

  • Department of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  • Kepler University Hospital, Johannes Kepler University, Linz, Austria
  • Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
  • Bharati Vidyapeeth Deemed University Medical College, Pune, India
  • Mulago National Referral Hospital, Kampala, Uganda
  • Division of Pulmonary and Critical Care Medicine, Atrium Health, Charlotte, NC, USA
  • Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
  • University of Pittsburgh, Pittsburgh, PA, USA
  • Hospital Sirio-Libanes, Saõ Paulo, Brazil
  • Karolinska Institute, Stockholm, Sweden
  • California Pacific Medical Center, San Francisco, CA, USA
  • Mayo Clinic, Jacksonville, FL, USA
  • Mahidol University, Bangkok, Thailand
  • Stony Brook University Medical Center, Stony Brook, NY, USA
  • Liverpool School of Tropical Medicine, Liverpool, UK
  • British Columbia Children’s Hospital, Vancouver, BC, Canada
  • All India Institute of Medical Science, Delhi, India
  • St. James’s University Hospital, Dublin, Ireland
  • Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
  • Aga Khan University Hospital, Nairobi, Kenya
  • Johannesburg Hospital, University of the Witwatersrand, Johannesburg, South Africa
  • Ispat General Hospital, Rourkela, Odisha, India
  • Seattle Children’s Hospital, University of Washington, Washington, WA, USA
  • Medical Intensive Care Unit, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
  • Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
  • Trung Vuong Hospital, Ho Chi Minh City, Vietnam
  • National University Hospital, Singapore, Singapore
  • Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  • Hospital de Sao Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
  • Appolo Hospitals, Chennai, India
  • Mzuzu Central Hospital, Mzuzu, Malawi
  • Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/978-3-030-03143-5_1

    DOI

    http://dx.doi.org/10.1007/978-3-030-03143-5_1

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1112026912


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