Critical care and severe sepsis in resource poor settings.

A M Dondorp,R Haniffa

doi:10.1093/trstmh/tru099

Abstract

Critical care and severe sepsis in resource poor settings.

Highlights

There have been impressive gains in public health in low- and middle-income countries in recent decades, which are contributing to significant reductions in infant mortality, malaria attributable mortality and a general improvement in life expectancy in these countries
The ‘Surviving Sepsis Campaign’ guidelines for severe sepsis and septic shock management[6] have been implemented widely in intensive care units (ICUs) in high-income countries and have, together with timely administration of essential therapies, contributed to improved survival. Part of these recommendations can be applied to more resource-limited settings at low or no extra costs. These include the use of low tidal volumes for mechanical ventilation, prompt start of appropriate empirical antibiotic treatment, restricted use of fluid therapy after the initial phase in septic shock and restricted use of sedation
The causes of severe sepsis are different in tropical countries and often require different approaches for their management

Summary

Introduction

There have been impressive gains in public health in low- and middle-income countries in recent decades, which are contributing to significant reductions in infant mortality, malaria attributable mortality and a general improvement in life expectancy in these countries. The ‘Surviving Sepsis Campaign’ guidelines for severe sepsis and septic shock management[6] have been implemented widely in ICUs in high-income countries and have, together with timely administration of essential therapies, contributed to improved survival. Part of these recommendations can be applied to more resource-limited settings at low or no extra costs.

Results

Conclusion