Surviving sepsis in low-income and middle-income countries: new directions for care and research
Surviving sepsis in low-income and middle-income countries: new directions for care and research
复制标题
DOI：
10.1016/s1473-3099(09)70135-5
复制
发表时间：
2009-09-01
影响因子：
56.3
通讯作者：
Groce, Nora Ellen
中科院分区：
文献类型：
--
作者：
Becker, Joseph U.;Theodosis, Christian;Groce, Nora Ellen
脓毒症是一种以继发于感染的全身性炎症为特征的疾病。尽管最近在脓毒症的理解和治疗方面取得了进展，但没有数据或建议详细说明资源有限的低收入和中等收入国家（LMIC）的脓毒症治疗的有效方法。尽管关于败血症在中低收入国家中的负担的数据很少，但一些中低收入国家中艾滋病毒和其他共病的患病率表明败血症是这些地区死亡率的重要因素。在资源充足的国家，脓毒症管理依赖于大多数中低收入国家不广泛使用的协议和复杂的侵入性技术。然而，脓毒症管理的关键概念和组成部分可能适用于资源有限的环境。应教育中低收入国家的卫生人员认识脓毒症以及早期和适当使用抗生素的重要性。应强调简单和低成本的标准化实验室检测，以实现准确的诊断、预后和监测治疗反应。因此，应制定和验证针对低收入国家生态和资源的循证干预措施和治疗算法。
Sepsis is a disorder characterised by systemic inflammation secondary to infection. Despite recent progress in the understanding and treatment of sepsis, no data or recommendations exist that detail effective approaches to sepsis care in resource-limited low-income and middle-income countries (LMICs). Although few data exist on the burden of sepsis in LMICs, the prevalence of HIV and other comorbid conditions in some LMICs suggest that sepsis is a substantial contributor to mortality in these regions. In well-resourced countries, sepsis management relies on protocols and complex invasive technologies not widely available in most LMICs. However, the key concepts and components of sepsis management are potentially translatable to resource-limited environments. Health personnel in LMICs should be educated in the recognition of sepsis and the importance of early and appropriate antibiotic use. Simple and low-cost standardised laboratory testing should be emphasised to allow accurate diagnosis, prognosis, and monitoring of treatment response. Evidence-based interventions and treatment algorithms tailored to LMIC ecology and resources should thus be developed and validated.