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Critical Care
Published in: Critical Care 1/2020

01-12-2020 | Care | Commentary

Challenges for the care delivery for critically ill COVID-19 patients in developing countries: the Brazilian perspective

Authors: Jorge I. F. Salluh, Thiago Lisboa, Fernando A. Bozza

Published in: Critical Care | Issue 1/2020

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Excerpt

The delivery of critical care is a major challenge for developing countries [1]. The inequity of access to an ICU bed, heterogeneous triage policies, a low staff/patient ratio and suboptimal adherence to evidence-based practices contribute to disproportionally high mortality of sepsis and acute respiratory distress syndrome in these countries [2‐5]. In addition, limited step-down and specialized ward beds’ availability further widens the gap between critical and non-critical care inside hospitals. …
Literature
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Schultz MJ, Dunser MW, Dondorp AM, Adhikari NK, Iyer S, Kwizera A et al Global Intensive Care Working Group of the European Society of Intensive Care Medicine. Current challenges in the management of sepsis in ICUs in resource-poor settings and suggestions for the future. Intensive Care Med 2017;43(5):612–624.
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Salluh JIF, Soares M, Singer M. Spreading the knowledge on the epidemiology of sepsis. Lancet Infect Dis. 2017;17(11):1104–6.CrossRef
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Bozza FA, Salluh JI. An urban perspective on sepsis in developing countries. Lancet Infect Dis. 2010;10(5):290–1.CrossRef
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Machado FR, Cavalcanti AB, Bozza FA, Ferreira EM, Angotti Carrara FS, et al. The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study. Lancet Infect Dis. 2017;17(11):1180–9.CrossRef
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Machado FR, Ferreira EM, Sousa JL, Silva C, Schippers P, et al; Latin American Sepsis Institute Network. Quality improvement initiatives in sepsis in an emerging country: does the institution’s main source of income influence the results? An analysis of 21,103 patients. Crit Care Med 2017;45(10):1650–1659.
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Managing ICU surge during the COVID-19 crisis: rapid guidelines. Aziz S, Arabi YM, Alhazzani W, Evans L, Citerio G, Fischkoff K, Salluh J et al. Intensive Care Med. 2020; 8:1–23.
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Salluh JI, Lisboa TC. Critical care in Brazil. ICU Manage Pract. 2016;16:3.
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Writing Group for the CHECKLIST-ICU Investigators and the Brazilian Research in Intensive Care Network (BRICNet), Cavalcanti AB, Bozza FA, Machado FR, Salluh JI, et al. Effect of a quality improvement intervention with daily round checklists, goal setting, and clinician prompting on mortality of critically ill patients: a randomized clinical trial. JAMA. 2016;315(14):1480–90.CrossRef
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Azevedo LC, Park M, Salluh JI, Rea-Neto A, Souza-Dantas VC et al.; ERICC (Epidemiology of Respiratory Insufficiency in Critical Care) investigators. Clinical outcomes of patients requiring ventilatory support in Brazilian intensive care units: a multicenter, prospective, cohort study. Crit Care. 2013;17(2):R63.
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Soares M, Bozza FA, Angus DC, Japiassú AM, Viana WN, Costa R, et al. Organizational characteristics, outcomes, and resource use in 78 Brazilian intensive care units: the ORCHESTRA study. Intensive Care Med. 2015;41(12):2149–60.
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Zampieri FG, Salluh JIF, Azevedo LCP, Kahn JM, Damiani LP, Borges LP, et al. ICU staffing feature phenotypes and their relationship with patients’ outcomes: an unsupervised machine learning analysis. Intensive Care Med. 2019;45(11):1599–607.CrossRef
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Midega TD, Bozza FA, Machado FR, Guimarães HP, Salluh JI, Nassar AP Jr, et al. Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database. Ann Intensive Care. 2020;10(1):68.CrossRef
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Metadata
Title
Challenges for the care delivery for critically ill COVID-19 patients in developing countries: the Brazilian perspective
Authors
Jorge I. F. Salluh
Thiago Lisboa
Fernando A. Bozza
Publication date
01-12-2020
Publisher
BioMed Central
Keywords
Care
COVID-19
Published in
Critical Care / Issue 1/2020
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-020-03278-7

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