Infrastructure and Organization of Adult Intensive Care Units in Resource-Limited Settings

Papali, Alfred; Adhikari, Neill K. J.; Dı́az, Janet; Dondorp, Arjen M.; Dünser, Martin W.; Jacob, Shevin T.; Phua, Jason; Romain, Marc; Schultz, Marcus J.

doi:10.1007/978-3-030-03143-5_3

Cited by 11 publications

(10 citation statements)

References 224 publications

(236 reference statements)

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“…The burden of life-threatening conditions requiring management in the intensive care unit has grown substantially in the last couple of decades in low and middle-income countries because of an emerging pandemic, motorization, urbanization, and hospital expansion [ [7] , [8] , [9] , [10] , [11] , [12] ]. However, the advancement of ICU care is very limited in these countries due to the high cost of infrastructure, training medical staff, failure to incorporate international guidelines for evidence-based care, and availing medical supplies([ 9 , 11 , [13] , [14] , [15] , [16] ]).…”

Section: Introductionmentioning

confidence: 99%

Survival and predictors of mortality among patients admitted to the intensive care units in southern Ethiopia: A multi-center cohort study

Abate

Assen

Yinges

et al. 2021

Annals of Medicine &Amp; Surgery

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Background The burden of life-threatening conditions requiring intensive care units has grown substantially in low-income countries related to an emerging pandemic, urbanization, and hospital expansion. The rate of ICU mortality varied from region to region in Ethiopia. However, the body of evidence on ICU mortality and its predictors is uncertain. This study was designed to investigate the pattern of disease and predictors of mortality in Southern Ethiopia. Methods After obtaining ethical clearance from the Institutional Review Board (IRB), a multi-center cohort study was conducted among three teaching referral hospital ICUs in Ethiopia from June 2018 to May 2020. Five hundred and seventeen Adult ICU patients were selected. Data were entered in Statistical Package for Social Sciences version 22 and STATA version 16 for analysis. Descriptive statistics were run to see the overall distribution of the variables. Chi-square test and odds ratio were determined to identify the association between independent and dependent variables. Multivariate analysis was conducted to control possible confounders and identify independent predictors of ICU mortality. Results The mean (±SD) of the patients admitted in ICU was 34.25(±5.25). The overall ICU mortality rate was 46.8%. The study identified different independent predictors of mortality. Patients with cardiac arrest were approximately 12 times more likely to die as compared to those who didn't, AOR = 11.9(95% CI:6.1 to 23.2). Conclusion The overall mortality rate in ICU was very high as compared to other studies in Ethiopia as well as globally which entails a rigorous activity from different stakeholders.

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Section: Introductionmentioning

confidence: 99%

Survival and predictors of mortality among patients admitted to the intensive care units in southern Ethiopia: A multi-center cohort study

Abate

Assen

Yinges

et al. 2021

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

show abstract

“…The burden of life-threatening conditions requiring management in the intensive care unit has grown substantially in the last couple of decades in low and middle-income countries because of an emerging pandemic, motorization, urbanization, and hospital expansion [7][8][9][10][11][12]. However, the advancement of ICU care is very limited in these countries due to the high cost of infrastructure, training medical staff, failure to incorporate international guidelines for evidence-based care, and availing medical supplies [9,11,[13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Survival and Predictors of Mortality Among Patients Admitted to Intensive Care Unit in Southern Ethiopia: A Multi-center Retrospective Cohort Study

Abate

Assen

Yinges

et al. 2020

Preprint

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Background: The burden of life-threatening conditions requiring intensive care unit has grown substantially in low-income countries related to an emerging pandemic, urbanization, and hospital expansion. The rate of ICU mortality is varied from region to region in Ethiopia. However, body of evidence on ICU mortality and its predictors is uncertain. This study was designed to investigate the pattern of disease and predictors of mortality in Southern Ethiopia.Methods: After obtaining Ethical clearance from institutional Review Board (IRB), a multi-center retrospective Cohort study was conducted among three teaching referral hospital ICUs of southern Ethiopia from June, 2018 to May, 2020. Five hundred and seventeen Adult ICU patients were selected. Data were entered in Statistical Package for Social Sciences version 22 and STATA version 16 for analysis. Descriptive statistics were run to see the overall distribution of the variables. Chi square test and odds ratio were determine to identify the association between independent and dependent variables. Multivariate analysis was conducted to control possible confounders and identify independent predictors of ICU mortality.Results: The mean (± SD) of the patients admitted in ICU was 34.25(±5.25). The overall ICU mortality rate was 46.8%. The study identified different independent predictors of mortality. Patients with cardiac arrest were approximately 12 times more likely to die as compared to who didn’t, AOR=11.9 (95% CI:6.1 to 23.2).Conclusion: The overall mortality rate in ICU was very high as compared to other studies in Ethiopia as well as globally which entails a rigorous activity from different stakeholders.

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“…Especially with diseases like COVID-19, donning isolation gowns and masks and intensive hand hygiene are part of standard precautions for extensive effort to reduce the spread of infection. Real-time contact-less patient monitoring of vital signs provides continuous monitoring of patient status as well as an additional resource for reducing added exposure to patient bodily fluids, excretions and secretions 12 , 13 . Electronic real-time monitoring is not only essential for vital sign monitoring but also would provide an added reduction of patient contact and urine bag manipulation required of manual measurements.…”

Section: Discussionmentioning

confidence: 99%

Automated versus manual urine output monitoring in the intensive care unit

Minor

Smith

Deutsch

et al. 2021

Sci Rep

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Acute kidney injury (AKI) is defined by changes in serum creatinine and urine output (UO). Significant limitations exist regarding accurate ascertainment of urine output even within the intensive care unit. We sought to evaluate an automated urine output collections system and compare it to nursing measurements. We prospectively collected urine output using an electronic urine monitoring system and compared it to charted hourly UO in 44 patients after cardiac surgery at a single university hospital ICU. We calculated UO and oliguria rates and compared them to data from the sensor and from nursing charting. A total of 187 hourly UO measurements were obtained and on average, UO was reported 47 min late, with a median of 18 min, and a maximum of almost 6 h. Patients had a mean hourly UO of 76.3 ml over the observation period. Compared to manual measurements by study personnel, nurses significantly overestimated hourly UO by 19.9 ml (95% CI: 10.3; 29.5; p = < 0.001). By contrast, the mean difference between the UO measured with the sensor and by study personnel was 2.29 ml (95% CI: − 6.7; 11.3), p = 0.61. Electronic UO monitoring is significantly more accurate than nurse-performed manual measurements in actual intensive care patients. Furthermore, timely ascertainment of UO is difficult to achieve with manual technique, resulting in important delays in detecting oliguria perhaps leading to missed cases of AKI.

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Infrastructure and Organization of Adult Intensive Care Units in Resource-Limited Settings

Cited by 11 publications

References 224 publications

Survival and predictors of mortality among patients admitted to the intensive care units in southern Ethiopia: A multi-center cohort study

Survival and predictors of mortality among patients admitted to the intensive care units in southern Ethiopia: A multi-center cohort study

Survival and Predictors of Mortality Among Patients Admitted to Intensive Care Unit in Southern Ethiopia: A Multi-center Retrospective Cohort Study

Automated versus manual urine output monitoring in the intensive care unit

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