Sepsis Management in Resource-Limited Settings.

• Author: Dondorp, Arjen M.
• TeilnehmendeR: Dünser, Martin W.; Schultz, Marcus J.
• Place / Publishing House: Cham : : Springer International Publishing AG,, 2019.; ©2019.
• Year of Publication: 2019
• Edition: 1st ed.
• Language: English
• Physical Description: 1 online resource (226 pages)

Table of Contents

Intro -- Foreword I -- Foreword II -- Preface -- Contents -- Contributors -- 1: Current Challenges in the Management of Sepsis in ICUs in Resource-Poor Settings and Suggestions for the Future -- 1.1 Introduction -- 1.2 Burden and Causes of Sepsis and Its Management -- 1.2.1 Disease Burden -- 1.2.2 Causative Pathogens and Pathogenesis -- 1.2.3 Poor Availability of Critical Care -- 1.2.4 Incomplete and Unadjusted Guidelines -- 1.3 Costs of Care in Sepsis -- 1.3.1 Expensive but Likely Cost-Effective Critical Care -- 1.3.2 Costs of Critical Care Among Regions -- 1.3.3 Benefit of Critical Care Among Regions -- 1.3.4 Impact of Certain Interventions Among Regions -- 1.4 Sepsis Research in Resource-Limited Settings -- 1.4.1 A Yet Largely Untouched Research Agenda -- 1.4.2 Challenges with Research in Resource-Restricted Settings -- 1.5 Suggestions for the Future -- 1.5.1 Better Definition of Sepsis -- 1.5.2 Better Research Infrastructures and Planning -- 1.5.3 Obtaining Relevant Evidence and Adapting Guidelines -- 1.5.4 Opportunities -- 1.6 Conclusions -- References -- 2: Development of the Guidelines: Focus on Availability, Feasibility, Affordability, and Safety of Interventions in Resource-Limited Settings -- 2.1 Introduction -- 2.2 Heads and Subheads -- 2.3 Other Subgroup Members -- 2.4 Meetings -- 2.5 Search Process -- 2.6 Grading of Recommendations -- 2.7 Reporting -- References -- 3: Infrastructure and Organization of Adult Intensive Care Units in Resource-Limited Settings -- 3.1 Introduction -- 3.2 Staffing -- 3.3 Training -- 3.4 Electricity -- 3.5 Oxygen -- 3.6 Hygiene -- 3.7 Equipment -- 3.8 Quality -- 3.9 Conclusions -- References -- 4: Recognition of Sepsis in Resource-Limited Settings -- 4.1 Introduction -- 4.2 Sepsis Recognition -- 4.3 Identification of the Underlying Type of Infection.

4.4 Identification of the Causative Microbiological Pathogen -- 4.5 Recognition of Septic Shock -- 4.6 Conclusions -- References -- 5: Core Elements of General Supportive Care for Patients with Sepsis and Septic Shock in Resource-Limited Settings -- 5.1 Introduction -- 5.2 Corticosteroids for Patients with Refractory Shock in Resource-Limited ICUs -- 5.3 Sedation for Patients with Sepsis in Resource-Limited ICUs -- 5.4 Neuromuscular Blocking Agents for Mechanical Ventilation -- 5.5 Deep Venous Thrombosis Prophylaxis in Resource-Limited ICUs -- 5.6 Stress Ulcer Prophylaxis in Patients with Sepsis in Resource-Limited ICUs -- 5.7 Glucose Control in Patients with Sepsis in Resource-Limited ICUs -- 5.8 Enteral Feeding in Patients with Sepsis in Resource-Limited ICUs -- 5.9 Dialysis in Patients with Sepsis-Induced Acute Kidney Damage in Resource-Limited ICUs -- 5.10 Fluid Strategies in Patients with Sepsis in Resource-Limited ICUs -- References -- 6: Ventilatory Support of Patients with Sepsis or Septic Shock in Resource-Limited Settings -- 6.1 Introduction -- 6.2 The Diagnosis of the Acute Respiratory Distress Syndrome (ARDS) -- 6.3 The Semi-recumbent Position -- 6.4 Noninvasive Ventilation (NIV) -- 6.5 Spontaneous Breathing Trials -- 6.6 Low Tidal Volumes -- 6.7 PEEP -- 6.8 Low Oxygen Fractions with High PEEP or High Oxygen Fractions with Low PEEP -- 6.9 Recruitment Maneuvers -- 6.10 Ventilation Modes -- References -- 7: Hemodynamic Assessment and Support in Sepsis and Septic Shock in Resource-Limited Settings -- 7.1 Introduction -- 7.2 Simple Bedside Tools to Assess Tissue Perfusion -- 7.3 The Passive Leg Raise Test and Other Simple Tools to Replace Direct Measurements of Cardiac Output -- 7.4 Fluid Strategies -- 7.5 Amounts and Timing of IV Fluids -- 7.6 Vasopressors and Inotropes -- 7.7 Conclusions -- References.

8: Infection Management in Patients with Sepsis and Septic Shock in Resource-Limited Settings -- 8.1 Introduction and Definitions -- 8.2 Factors Guiding the Choice of Empiric Antibiotic Choice in Sepsis and Septic Shock in Resource-Limited Settings -- 8.2.1 Bacterial Pathogens -- 8.2.2 Antimicrobial Resistance -- 8.2.3 Appropriateness of Antibiotic Choices -- 8.2.4 Costs -- 8.2.5 Availability, Feasibility, Affordability, and Safety -- 8.3 Timing of Antibiotic Treatment -- 8.3.1 Availability, Feasibility, and Affordability -- 8.4 Importance of Blood Cultures Before Initiation of Empirical Antibiotic Treatment -- 8.4.1 Availability, Feasibility, and Affordability -- 8.5 Source Control -- 8.5.1 Availability, Affordability, and Feasibility -- 8.6 Use of Combination Antibiotic Therapy in Specific Situations -- 8.6.1 Availability, Affordability, and Feasibility -- 8.7 Use of Procalcitonin (PCT), C-Reactive Protein (CRP), or Other Biomarkers for De-escalation of Antibiotics -- 8.7.1 Availability, Affordability, and Feasibility -- 8.8 Outstanding Questions for Future Research -- References -- 9: Management of Severe Malaria and Severe Dengue in Resource- Limited Settings -- 9.1 Introduction -- 9.2 Fluid Management in Severe Malaria -- 9.3 Timing of Enteral Nasogastric Tube Feeding in Cerebral Malaria -- 9.4 Mechanical Ventilation in Patients with Severe Malaria and Acute Respiratory Distress Syndrome -- 9.5 Fluid Management in Severe Dengue -- 9.6 Use of Corticosteroids in Severe Dengue -- 9.7 Preventive Platelet Transfusion in Patients with Severe Dengue -- 9.8 Conclusions -- References -- 10: Pediatric Sepsis and Septic Shock Management in Resource- Limited Settings -- 10.1 Introduction -- 10.2 Identification of Septic Shock in Children -- 10.3 Intraosseous Access as Initial Vascular Access in Septic Children.

10.4 Bolus Fluids or Blood to Malnourished Children with Signs of Severe Sepsis -- 10.5 Bolus Fluid Resuscitation with 5% Albumin or Normal Saline, Compared to No Bolus Fluids, in Pediatric Sepsis -- 10.6 Should Sepsis Management Be Guided by Goal-Directed Protocols of Care for Children in Resource-Limited Settings? -- 10.7 Is Transfusion Recommended for Children with Anemia and Sepsis Due to Severe Malaria in Resource-Limited Settings? -- 10.8 Noninvasive Ventilation for Children with Acute Respiratory Distress from Sepsis in Resource-Limited Settings -- 10.9 Should Low Tidal Volume Ventilation Be Recommended for Children with Acute Lung Injury from Sepsis in Resource-Limited ICUs? -- References.