The global burden of sepsis: barriers and potential solutions

被引：258

作者：

Rudd, Kristina E. ^{[1
,2
,3
]}

Kissoon, Niranjan ^{[4
]}

Limmathurotsakul, Direk ^{[5
,6
]}

Bory, Sotharith ^{[7
]}

Mutahunga, Birungi ^{[8
]}

Seymour, Christopher W. ^{[3
,9
]}

Angus, Derek C. ^{[3
,10
]}

West, T. Eoin ^{[1
,2
,11
]}

机构：

[1] Univ Washington, Int Resp & Severe Illness Ctr, Seattle, WA 98195 USA

[2] Univ Washington, Div Pulm Crit Care & Sleep Med, Dept Med, Seattle, WA 98195 USA

[3] Univ Pittsburgh, Dept Crit Care Med, Sch Med, 3550 Terrace St,Scaife Hall 639, Pittsburgh, PA 15261 USA

[4] Univ British Columbia, British Columbia Childrens Hosp, Div Crit Care, Dept Pediat, Vancouver, BC, Canada

[5] Mahidol Univ, Mahidol Oxford Trop Med Res Unit, Bangkok, Thailand

[6] Univ Oxford, Nuffield Dept Med, Ctr Trop Med & Global Hlth, Oxford, England

[7] Calmette Hosp, Div Infect Dis, Dept Med, Phnom Penh, Cambodia

[8] Bwindi Community Hosp, Kanungu, Uganda

[9] Univ Pittsburgh, Sch Med, Dept Emergency Med, Pittsburgh, PA USA

[10] UPMC Hlth Syst, Pittsburgh, PA USA

[11] Univ Washington, Dept Global Hlth, Seattle, WA 98195 USA

来源：

CRITICAL CARE | 2018年 / 22卷

基金：

美国国家卫生研究院;

关键词：

Health resources; Poverty; Public health; Sepsis; Low-income countries; INTERNATIONAL CONSENSUS DEFINITIONS; GOAL-DIRECTED THERAPY; SEPTIC SHOCK; LABORATORY CAPACITY; INTENSIVE-CARE; RISK-FACTORS; MORTALITY; CHILDREN; GUIDELINES; MANAGEMENT;

D O I：

10.1186/s13054-018-2157-z

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Sepsis is a major contributor to the global burden of disease. The majority of sepsis cases and deaths are estimated to occur in low and middle-income countries. Barriers to reducing the global burden of sepsis include difficulty quantifying attributable morbidity and mortality, low awareness, poverty and health inequity, and under-resourced and low-resilience public health and acute health care delivery systems. Important differences in the populations at risk, infecting pathogens, and clinical capacity to manage sepsis in high and low-resource settings necessitate context-specific approaches to this significant problem. We review these challenges and propose strategies to overcome them. These strategies include strengthening health systems, accurately identifying and quantifying sepsis cases, conducting inclusive research, establishing data-driven and context-specific management guidelines, promoting creative clinical interventions, and advocacy.

引用

页数：11

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