Systems for Pediatric Sepsis: A Global Survey

Kang, Kristopher T.; Chandler, HK; Espinosa, V.; Kissoon, Niranjan

doi:10.7727/wimj.2013.326

Cited by 12 publications

(12 citation statements)

References 32 publications

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“…With only 1.7% of all biomedical research publications originating in LMICs [73], and a likely even greater disparity in critical care [44], both the needs and the opportunities for critical care research are vast. Recent rigorous attempts to quantify the global burdens of sepsis, infection, and respiratory failure confirm a profound lack of epidemiologic critical illness data from LMICs, with the only reliable data limited to single-center descriptions [68,[74][75][76][77]. The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC), the Global Intensive Care Working Group of the ESICM, and the Mahidol Oxford Research Unit in Bangkok, Thailand, are three examples of groups working to create the infrastructure for global epidemiologic data on critical illness, for use both as baseline data at regular intervals and in preparation for disease outbreaks [78].…”

Section: A Yet Largely Untouched Research Agendamentioning

confidence: 99%

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

Schultz

Dünser

Dondorp

et al. 2019

Sepsis Management in Resource-Limited Settings

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Section: A Yet Largely Untouched Research Agendamentioning

confidence: 99%

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

Schultz

Dünser

Dondorp

et al. 2019

Sepsis Management in Resource-Limited Settings

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“…With only 1.7% of all biomedical research publications originating in low-income countries [72] and a likely even greater disparity in critical care [44], both the needs and the opportunities for critical care research are vast. Recent rigorous attempts to quantify the global burdens of sepsis, infection and respiratory failure confirm a profound lack of data on epidemiologic critical illness from low-income countries, with the only reliable data limited to single-center descriptions [67,[73][74][75][76]. The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC), the Global Intensive Care Working Group of the ESICM and the Mahidol Oxford Research Unit in Bangkok, Thailand, are three examples of groups working to create the infrastructure for global epidemiologic data on critical illness, for use both as baseline data at regular intervals but also in preparation for disease outbreaks [77].…”

Section: A Yet Largely Untouched Research Agendamentioning

confidence: 99%

Current challenges in the management of sepsis in ICUs in resource-poor settings and suggestions for the future

et al. 2017

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Background: Sepsis is a major reason for intensive care unit (ICU) admission, also in resource-poor settings. ICUs in low-and middle-income countries (LMICs) face many challenges that could affect patient outcome. Aim: 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 even knowing that many sepsis patients in LMICs are treated outside an ICU. Findings: 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 sometimes be more important than the response of the host. There are substantial and persisting differences in ICU capacities around the world; not surprisingly the lowest capacities are found in LMICs, but with important heterogeneity within individual LMICs. Although many aspects of sepsis management developed in rich countries are applicable in LMICs, implementation requires strong consideration of cost implications and the important differences in resources. Conclusions: Addressing both disease-specific and setting-specific factors is important to improve performance of ICUs in LMICs. Although critical care for severe sepsis is likely cost-effective in LMIC setting, more detailed evaluation at both at 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.

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“…The institutions in Nigeria did not require IRB approval for the survey. The online survey instrument designed by the World Federation of Pediatric Intensive and Critical Care Societies (WFPICCS) was modified and used to address all aspects of pediatric sepsis identification, management, barriers, and readiness (14). We modified the survey to reflect the local health practices and environment in Nigeria, such as replacing the Pediatric Specialist designation with Consultant Pediatrician, and the types of health facility as Teaching Hospitals, Federal Medical Centers (FMCs) and Other (Specialist Hospitals).…”

Section: Methodsmentioning

confidence: 99%

A National Survey of Resources to Address Sepsis in Children in Tertiary Care Centers in Nigeria

et al. 2019

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Background: Infections leading to sepsis are major contributors to mortality and morbidity in children world-wide. Determining the capacity of pediatric hospitals in Nigeria to manage sepsis establishes an important baseline for quality-improvement interventions and resource allocations. Objectives: To assess the availability and functionality of resources and manpower for early detection and prompt management of sepsis in children at tertiary pediatric centers in Nigeria. Methods: This was an online survey of tertiary pediatric hospitals in Nigeria using a modified survey tool designed by the World Federation of Pediatric Intensive and Critical Care Societies (WFPICCS). The survey addressed all aspects of pediatric sepsis identification, management, barriers and readiness. Results: While majority of the hospitals 97% (28/29) reported having adequate triage systems, only 60% (16/27) follow some form of guideline for sepsis management. There was no consensus national guideline for management of pediatric sepsis. Over 50% of the respondents identified deficit in parental education, poor access to healthcare services, failure to diagnose sepsis at referring institutions, lack of medical equipment and lack of a definitive protocol for managing pediatric sepsis, as significant barriers. Conclusions: Certain sepsis-related interventions were reportedly widespread, however, there is no standardized sepsis protocol, and majority of the hospitals do not have pediatric intensive care units (PICU). These findings could guide quality improvement measures at institutional level, and healthcare policy/spending at the national level.

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Systems for Pediatric Sepsis: A Global Survey

Cited by 12 publications

References 32 publications

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

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

Current challenges in the management of sepsis in ICUs in resource-poor settings and suggestions for the future

A National Survey of Resources to Address Sepsis in Children in Tertiary Care Centers in Nigeria

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