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Intensive Care Medicine

, Volume 44, Issue 7, pp 1133–1137 | Cite as

Recommendations on infrastructure and organization of adult ICUs in resource-limited settings

  • Alfred PapaliEmail author
  • Marcus J. Schultz
  • Martin W. Dünser
  • for the European Society of Intensive Care Medicine (ESICM) Global Intensive Care working group and The Mahidol–Oxford Research Unit (MORU) in Bangkok, Thailand
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Introduction

Published guidelines regarding optimal infrastructure and organization of intensive care units (ICUs) are based on evidence primarily from resource-rich settings [1, 2]. These guidelines may be less applicable to resource-limited settings [3]. An international team of physicians from the Mahidol–Oxford Tropical Medicine Research Unit and the Global Intensive Care working group of the European Society of Intensive Care Medicine, all with extensive experience in resource-limited ICUs, evaluated a list of seven clearly defined questions regarding ICU organization in resource-limited settings using literature review and a modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool [4]. Evidence quality was scored from very high (A) to very low (D), and recommendation strength was strong (1) or weak (2). Availability, feasibility, affordability and safety of recommendations in resource-limited settings were specially emphasized (Table 1). Full...

Notes

Acknowlegements

Group members of the ‘Sepsis in Resource-limited Settings’—guidelines group and the ‘Mahidol–Oxford Research Unit’ (MORU) in Bangkok, Thailand: (Heads) Arjen D. Dondorp (Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand and Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands), Martin W. Dünser (Department of Critical Care, University College of London Hospital, London, UK), and Marcus J. Schultz (Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands and Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand).

Other group members: Neill K.J. Adhikari (Sunnybrook Health Sciences Centre and University of Toronto, Toronto, ON, Canada), Derek Angus (University of Pittsburgh, Pittsburgh, PA), Luciano Azevedo (Hospital Sirio-Libanes, Saõ Paulo, Brazil), Janet V. Diaz (Pacific Medical Center, San Francisco, USA and World Health Organization, Geneva, Switzerland), Arthur Kwizera (Mulago National Referral Hospital, Kampala, Uganda), Tim Baker (Karolinska Institute, Stockholm, Sweden), Ted Barnett (The Ochsner Medical Center, New Orleans, Louisiana), Chris Farmer (Mayo Clinic, Rochester, MI), Rashan Haniffa (Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand), Shevin T. Jacob (University of Washington School of Medicine, Seattle, USA and World Health Organization, Geneva, Switzerland), Randeep Jawa (Stony Brook University Medical Center, Stony Brook, NY, USA), Niranjan Kissoon (British Columbia Children’s Hospital and University of British Columbia, Vancouver, Canada), Rakesh Lodha (All India Institute of Medical Sciences, Delhi, India), Ganbold Lundeg (Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia), Ignacio Martin Loeches (St. James's University Hospital, Dublin, Ireland), David Misango (Aga Khan University Hospital, Nairobi, Kenya), Mervyn Mer (Johannesburg Hospital and University of the Witwatersrand, Johannesburg, South Africa), Sanjib Mohanty (Ispat General Hospital, Rourkela, Sundargarh, Odisha, India), Srinivas Murthy (BC Children’s Hospital, University of British Columbia, Vancouver, Canada), Ndidiamaka Musa (Seattle Children’s Hospital and University of Washington, WA), Jane Nakibuuka (Mulago National referral and university teaching hospital, Kampala, Uganda), Mai Nguyen Thi Hoang (Oxford University Clinical Research Unit, Ho Chi Minh City, District 5, Vietnam), Binh Nguyen Thien (Trung Vuong Hospital, Ho Chi Minh City, Viet Nam), Alfred Papali (University of Maryland School of Medicine, Baltimore, USA), Rajyabardhan Pattnaik (Ispat General Hospital, Rourkela, Sundargarh, Odisha, India),Jason Phua (National University Hospital, Singapore), Luigi Pisani (University of Bari Aldo Moro, Bari, Italy), Jacobus Preller (Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK), Pedro Povoa (Nova Medical School, CEDOC, New University of Lisbon, Lisbon, Portugal and Hospital de São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal), Suchitra Ranjit (Appolo’s Hospitals, Chennai, India), Elisabeth D. Riviello (Brigham and Women’s Hospital, Boston, USA), Marc Romain (Hadassah–Hebrew University Medical Center, Jerusalem, Israel), Ary Serpa-Neto (Hospital Israelita Albert Einstein, São Paulo, Brazil), Jonarthan Thevanayagam (Mzuzu Central Hospital, Mzuzu, Malawi), and Louise Thwaites (Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK).

Group members of the subgroup ‘Infrastructure and Organization of ICUs in Resource-limited settings’: (Heads) Alfred Papali (University of Maryland School of Medicine, Baltimore, USA), Marcus J. Schultz (Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands and Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand), and Martin W. Dünser (Department of Critical Care, University College of London Hospital, London, UK).

Other subgroup members: Neill J. Adhikari (Sunnybrook Health Sciences Centre, University of Toronto Canada), Janet V. Diaz (Pacific Medical Center, San Francisco, USA and World Health Organization, Geneva, Switzerland), Arjen M. Dondorp (Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand), Shevin T. Jacob (University of Washington School of Medicine, Seattle, USA and World Health Organization, Geneva, Switzerland), Jason Phua (National University Hospital, Singapore), and Marc Romain (Hadassah-Hebrew University Medical Center, Jerusalem, Israel).

Compliance with ethical standards

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

134_2017_4972_MOESM1_ESM.docx (847 kb)
Supplementary material 1 (DOCX 846 kb)

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Copyright information

© Springer-Verlag GmbH Germany and ESICM 2017

Authors and Affiliations

  • Alfred Papali
    • 1
    • 2
    Email author
  • Marcus J. Schultz
    • 3
    • 4
    • 5
  • Martin W. Dünser
    • 6
  • for the European Society of Intensive Care Medicine (ESICM) Global Intensive Care working group and The Mahidol–Oxford Research Unit (MORU) in Bangkok, Thailand
  1. 1.Division of Pulmonary and Critical CareUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Institute for Global HealthUniversity of Maryland School of MedicineBaltimoreUSA
  3. 3.Mahidol–Oxford Research Unit (MORU), Faculty of Tropical MedicineMahidol UniversityBangkokThailand
  4. 4.Department of Intensive CareAcademic Medical CenterAmsterdamThe Netherlands
  5. 5.Laboratory of Experimental Intensive Care and Anesthesiology (LEICA)Academic Medical CenterAmsterdamThe Netherlands
  6. 6.Clinic of Anesthesiology and Intensive Care MedicineJohannes Kepler UniversityLinzAustria

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