Global Critical Care: Moving Forward in Resource-Limited Settings

Caring for critically ill patients is challenging in resource-limited settings, where the burden of disease and mortality from potentially treatable illnesses is higher than in resource-rich areas. Barriers to delivering quality critical care in these settings include lack of epidemiologic data and...

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Veröffentlicht in:Annals of global health Jg. 85; H. 1; S. 3
Hauptverfasser: Diaz, Janet V., Riviello, Elisabeth D., Papali, Alfred, Adhikari, Neill K. J., Ferreira, Juliana C.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Ubiquity Press 22.01.2019
Schlagworte:
Capacity development
Clinical trials
Critical care
Decision making
Disease
Education
Epidemiology
Health care access
Illnesses
Infrastructure
Intensive care
International organizations
Mass casualty incidents
Medical personnel
Mortality
Pandemics
Patients
Professionals
Quality improvement
Review
Sepsis
ISSN:2214-9996, 2214-9996
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Abstract Caring for critically ill patients is challenging in resource-limited settings, where the burden of disease and mortality from potentially treatable illnesses is higher than in resource-rich areas. Barriers to delivering quality critical care in these settings include lack of epidemiologic data and context-specific evidence for medical decision-making, deficiencies in health systems organization and resources, and institutional obstacles to implementation of life-saving interventions. Potential solutions include the development of common definitions for intensive care unit (ICU), intensivist, and intensive care to create a universal ICU organization framework; development of educational programs for capacity building of health care professionals working in resource-limited settings; global prioritization of epidemiologic and clinical research in resource-limited settings to conduct timely and ethical studies in response to emerging threats; adaptation of international guidelines to promote implementation of evidence-based care; and strengthening of health systems that integrates these interventions. This manuscript reviews the field of global critical care, barriers to safe high-quality care, and potential solutions to existing challenges. We also suggest a roadmap for improving the treatment of critically ill patients in resource-limited settings.
AbstractList Caring for critically ill patients is challenging in resource-limited settings, where the burden of disease and mortality from potentially treatable illnesses is higher than in resource-rich areas. Barriers to delivering quality critical care in these settings include lack of epidemiologic data and context-specific evidence for medical decision-making, deficiencies in health systems organization and resources, and institutional obstacles to implementation of life-saving interventions. Potential solutions include the development of common definitions for intensive care unit (ICU), intensivist, and intensive care to create a universal ICU organization framework; development of educational programs for capacity building of health care professionals working in resource-limited settings; global prioritization of epidemiologic and clinical research in resource-limited settings to conduct timely and ethical studies in response to emerging threats; adaptation of international guidelines to promote implementation of evidence-based care; and strengthening of health systems that integrates these interventions. This manuscript reviews the field of global critical care, barriers to safe high-quality care, and potential solutions to existing challenges. We also suggest a roadmap for improving the treatment of critically ill patients in resource-limited settings.
Caring for critically ill patients is challenging in resource-limited settings, where the burden of disease and mortality from potentially treatable illnesses is higher than in resource-rich areas. Barriers to delivering quality critical care in these settings include lack of epidemiologic data and context-specific evidence for medical decision-making, deficiencies in health systems organization and resources, and institutional obstacles to implementation of life-saving interventions. Potential solutions include the development of common definitions for intensive care unit (ICU), intensivist, and intensive care to create a universal ICU organization framework; development of educational programs for capacity building of health care professionals working in resource-limited settings; global prioritization of epidemiologic and clinical research in resource-limited settings to conduct timely and ethical studies in response to emerging threats; adaptation of international guidelines to promote implementation of evidence-based care; and strengthening of health systems that integrates these interventions. This manuscript reviews the field of global critical care, barriers to safe high-quality care, and potential solutions to existing challenges. We also suggest a roadmap for improving the treatment of critically ill patients in resource-limited settings.Caring for critically ill patients is challenging in resource-limited settings, where the burden of disease and mortality from potentially treatable illnesses is higher than in resource-rich areas. Barriers to delivering quality critical care in these settings include lack of epidemiologic data and context-specific evidence for medical decision-making, deficiencies in health systems organization and resources, and institutional obstacles to implementation of life-saving interventions. Potential solutions include the development of common definitions for intensive care unit (ICU), intensivist, and intensive care to create a universal ICU organization framework; development of educational programs for capacity building of health care professionals working in resource-limited settings; global prioritization of epidemiologic and clinical research in resource-limited settings to conduct timely and ethical studies in response to emerging threats; adaptation of international guidelines to promote implementation of evidence-based care; and strengthening of health systems that integrates these interventions. This manuscript reviews the field of global critical care, barriers to safe high-quality care, and potential solutions to existing challenges. We also suggest a roadmap for improving the treatment of critically ill patients in resource-limited settings.
Author Papali, Alfred
Ferreira, Juliana C.
Diaz, Janet V.
Adhikari, Neill K. J.
Riviello, Elisabeth D.
AuthorAffiliation 1 California Pacific Medical Center, San Francisco, CA, US
3 Atrium Health, Charlotte, NC, US
6 Department of Critical Care Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, CA
2 Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, US
4 University of Maryland School of Medicine, Baltimore, MD, US
5 University of North Carolina School of Medicine, Chapel Hill, NC, US
7 Divisao de Pneumologia, Instituto do Coracao, Hospital das Clinicas da Faculdade de Medicina HCFMUSP, Universidade de Sao Paulo, São Paulo, BR
AuthorAffiliation_xml – name: 1 California Pacific Medical Center, San Francisco, CA, US
– name: 7 Divisao de Pneumologia, Instituto do Coracao, Hospital das Clinicas da Faculdade de Medicina HCFMUSP, Universidade de Sao Paulo, São Paulo, BR
– name: 2 Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, US
– name: 5 University of North Carolina School of Medicine, Chapel Hill, NC, US
– name: 4 University of Maryland School of Medicine, Baltimore, MD, US
– name: 3 Atrium Health, Charlotte, NC, US
– name: 6 Department of Critical Care Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, CA
Author_xml – sequence: 1
  givenname: Janet V.
  surname: Diaz
  fullname: Diaz, Janet V.
– sequence: 2
  givenname: Elisabeth D.
  surname: Riviello
  fullname: Riviello, Elisabeth D.
– sequence: 3
  givenname: Alfred
  surname: Papali
  fullname: Papali, Alfred
– sequence: 4
  givenname: Neill K. J.
  surname: Adhikari
  fullname: Adhikari, Neill K. J.
– sequence: 5
  givenname: Juliana C.
  surname: Ferreira
  fullname: Ferreira, Juliana C.
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30741504$$D View this record in MEDLINE/PubMed
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(key20190122085347_B37) 2012; 16
(key20190122085347_B28) 2015; 385
(key20190122085347_B17) 2013; 17
(key20190122085347_B40) 2015; 10
(key20190122085347_B49) 2016; 10
(key20190122085347_B83) 2014; 40
(key20190122085347_B50) 2015; 30
(key20190122085347_B104) 2012; 7
(key20190122085347_B56) 2013; 18
(key20190122085347_B65) 2008; 24
(key20190122085347_B4) 2010; 376
(key20190122085347_B48) 2017; 318
key20190122085347_B23
(key20190122085347_B47) 2014; 42
(key20190122085347_B45) 2008; 36
(key20190122085347_B66) 2011; 26
(key20190122085347_B33) 2015; 10
(key20190122085347_B22) 2014; 9
(key20190122085347_B18) 2016; 6
Writing Group for the CHECKLIST-ICU Investigators and the Brazilian Research in Intensive Care Network (BRICNet) (key20190122085347_B88) 2016; 315
(key20190122085347_B25) 2015; 7
(key20190122085347_B91) 2014; 14
(key20190122085347_B12) 2012; 5
(key20190122085347_B58) 2006; 32
(key20190122085347_B39) 2016; 35
(key20190122085347_B68) 2010; 34
(key20190122085347_B34) 2011; 39
(key20190122085347_B51) 2011; 15
(key20190122085347_B59) 2005; 31
(key20190122085347_B61) 2013; 8
(key20190122085347_B105) 2017; 41
(key20190122085347_B1) 2017; 37
(key20190122085347_B87) 2014; 40
(key20190122085347_B30) 2003; 348
(key20190122085347_B57) 2015; 10
(key20190122085347_B5) 2014; 2
(key20190122085347_B41) 2016; 160
(key20190122085347_B86) 2017; 43
(key20190122085347_B78) 2017; 5
(key20190122085347_B81) 2016; 315
(key20190122085347_B35) 2017; 45
31276333 - Ann Glob Health. 2019 Jul 04;85(1)
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– reference: 31276333 - Ann Glob Health. 2019 Jul 04;85(1):
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SubjectTerms Capacity development
Clinical trials
Critical care
Decision making
Disease
Education
Epidemiology
Health care access
Illnesses
Infrastructure
Intensive care
International organizations
Mass casualty incidents
Medical personnel
Mortality
Pandemics
Patients
Professionals
Quality improvement
Review
Sepsis
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