-
Narrative Review10-02-2025
Rapid Response Teams in low and middle-income countries: a scoping review
- Larissa Bianchini
, - Luiz Marcelo Almeida de Araújo ,
- Daryl Jones ,
- Bruno Adler Maccagnan Pinheiro Besen
Abstract
Narrative ReviewRapid Response Teams in low and middle-income countries: a scoping review
Critical Care Science. 2025;37:e20250155
DOI 10.62675/2965-2774.20250155
- Larissa Bianchini ,
- Luiz Marcelo Almeida de Araújo ,
- Daryl Jones ,
- Bruno Adler Maccagnan Pinheiro Besen
Views209ABSTRACT
Background
Rapid Response Teams have been widely implemented in high-income countries and play a crucial role in the early identification and management of clinically deteriorating patients. However, their implementation in low and middle-income settings has not been adequately described. Our goal was to map the current evidence in this setting.
Methods
We conducted a scoping review to map the published literature about Rapid Response Teams in low- and middle-income countries, according to year of publication, study type, team composition, reported outcomes, and potential roles of the team.
Results
After screening 6,679 studies, 52 fulfilled eligibility criteria: 36 full-text studies and 16 conference abstracts. Most of the studies were from Brazil (51.2%), followed by India (19.2%) and Turkey (7.7%), with the two earliest reports being conference abstracts published in 2009. The predominant design was before-and-after studies (20; 38.4%), followed by cohort studies (16; 30.8%). An intensive care unit physician was always a member of the Rapid Response Teams in 55.9% of the studies and an intensive care unit nurse in 23.5%. The number of Rapid Response Teams calls in the before-and-after studies ranged from 2.39 to 124 per 1,000 admissions. Reported outcomes varied, with most studies focusing on mortality (26, 50%) and code blue incidence (21; 40.4%). Four (7.7%) studies reported an active role of Rapid Response Teams in goals of care discussions.
Conclusion
We found that evidence on Rapid Response Teams in low- and middle-income countries remains limited, with a time lag in publications compared to high-income countries. Our findings highlight the need for further studies and policy initiatives to evaluate the effectiveness of implementing Rapid Response Teams in resource-constrained settings.
Keywords:BrazilCardiopulmonary Resuscitationcritical illnessDeveloping countriesGoalsHospital rapid response teamIncidenceintensive care unitsPatient care planningPatient-reported outcome measuresSee moreViews209
Abstract
Narrative ReviewRapid Response Teams in low and middle-income countries: a scoping review
Critical Care Science. 2025;37:e20250155
DOI 10.62675/2965-2774.20250155
- Larissa Bianchini ,
- Luiz Marcelo Almeida de Araújo ,
- Daryl Jones ,
- Bruno Adler Maccagnan Pinheiro Besen
Views209ABSTRACT
Background
Rapid Response Teams have been widely implemented in high-income countries and play a crucial role in the early identification and management of clinically deteriorating patients. However, their implementation in low and middle-income settings has not been adequately described. Our goal was to map the current evidence in this setting.
Methods
We conducted a scoping review to map the published literature about Rapid Response Teams in low- and middle-income countries, according to year of publication, study type, team composition, reported outcomes, and potential roles of the team.
Results
After screening 6,679 studies, 52 fulfilled eligibility criteria: 36 full-text studies and 16 conference abstracts. Most of the studies were from Brazil (51.2%), followed by India (19.2%) and Turkey (7.7%), with the two earliest reports being conference abstracts published in 2009. The predominant design was before-and-after studies (20; 38.4%), followed by cohort studies (16; 30.8%). An intensive care unit physician was always a member of the Rapid Response Teams in 55.9% of the studies and an intensive care unit nurse in 23.5%. The number of Rapid Response Teams calls in the before-and-after studies ranged from 2.39 to 124 per 1,000 admissions. Reported outcomes varied, with most studies focusing on mortality (26, 50%) and code blue incidence (21; 40.4%). Four (7.7%) studies reported an active role of Rapid Response Teams in goals of care discussions.
Conclusion
We found that evidence on Rapid Response Teams in low- and middle-income countries remains limited, with a time lag in publications compared to high-income countries. Our findings highlight the need for further studies and policy initiatives to evaluate the effectiveness of implementing Rapid Response Teams in resource-constrained settings.
Keywords:BrazilCardiopulmonary Resuscitationcritical illnessDeveloping countriesGoalsHospital rapid response teamIncidenceintensive care unitsPatient care planningPatient-reported outcome measuresSee more
- Larissa Bianchini
-
CLINICAL REPORT09-22-2025
Potentially MOdifiable factors To ImproVe outcomes of mechanically Ventilated patients in a low-income country Intensive Care Units (MOTIVATE-ICU): rationale and protocol for a registry-embedded prospective observational study
- Cornelius Sendagire ,
- Luigi Pisani ,
- Alice Nuwagira ,
- Adam Hewitt-Smith ,
- Jane Nakibuuka , [ ... ],
- Jorge Ibrain Figueira Salluh
Abstract
CLINICAL REPORTPotentially MOdifiable factors To ImproVe outcomes of mechanically Ventilated patients in a low-income country Intensive Care Units (MOTIVATE-ICU): rationale and protocol for a registry-embedded prospective observational study
Critical Care Science. 2025;37:e20250273
DOI 10.62675/2965-2774.20250273
- Cornelius Sendagire ,
- Luigi Pisani ,
- Alice Nuwagira ,
- Adam Hewitt-Smith ,
- Jane Nakibuuka ,
- Herbert Kiwalya ,
- Nodreen Christine Ayupo ,
- Dominic Ogwal,
- Dennis Kakaire ,
- Patience Atumanya ,
- Betty Khainza,
- Hajara Nakayiza,
- Hawa Nakandi,
- Kenneth Tomanya,
- Martha Alupo ,
- Lameck Ssemogerere ,
- Erasmus Okello,
- Aggrey Lubikire ,
- Andrew Kintu ,
- Innocent Nyeko ,
- Andrew Kamau ,
- Chamira Kodippily ,
- Arthur Kwizera ,
- ,
- Abigail Beane ,
- Rashan Haniffa ,
- Jorge Ibrain Figueira Salluh
Views280ABSTRACT
Objective
To identify modifiable intensive care unit factors associated with outcomes among patients receiving invasive mechanical ventilation in a low-income setting.
Methods
This prospective, multicenter, registry-embedded observational study has two components: a prospective registry-based cohort assessing patient- and care-process-related factors and a cross-sectional intensive care unit survey evaluating organizational structure. Functional intensive care units in Uganda will be included. Patients aged ≥ 15 years old requiring invasive mechanical ventilation will be enrolled. Patients extubated within 48 hours, transferred after > 24 hours, and imminent early death will be excluded. Primary outcomes will include 28-day intensive care unit mortality, intensive care unit length of stay, and mechanical ventilation duration. Tracheostomy-related outcomes will be explored in a pre-planned sub-study. Factors potentially associated with outcomes will be categorized into non-modifiable and potentially modifiable factors. Non-modifiable factors will include patient-related factors like age, comorbidities, and illness severity; potentially modifiable factors include processes of care (e.g., sedation levels) and intensive care unit organizational structure (e.g., staffing patterns). Multilevel multivariable logistic regression models will assess association outcomes. Survival analysis (Kaplan-Meier curves) will explore mortality trends. Confounders will be identified using directed acyclic graphs.
Results (anticipated findings)
This study will generate high-quality data on modifiable intensive care unit factors associated with ventilated patient outcomes in low-resource settings.
Conclusion
This is Uganda’s first registry-embedded, multicenter intensive care unit study to systematically potentially modifiable factors associated with ventilated patient outcomes. This study will provide evidence-based insights to optimize critical care management in low- and middle-income countries by leveraging real-time intensive care unit registry data.
Keywords:critical careDeveloping countriesintensive care unitsLength of stayRegistriesRespiration, artificialRoutinely collected health dataSurvival analysistracheostomyUgandaSee moreViews280Abstract
CLINICAL REPORTPotentially MOdifiable factors To ImproVe outcomes of mechanically Ventilated patients in a low-income country Intensive Care Units (MOTIVATE-ICU): rationale and protocol for a registry-embedded prospective observational study
Critical Care Science. 2025;37:e20250273
DOI 10.62675/2965-2774.20250273
- Cornelius Sendagire ,
- Luigi Pisani ,
- Alice Nuwagira ,
- Adam Hewitt-Smith ,
- Jane Nakibuuka ,
- Herbert Kiwalya ,
- Nodreen Christine Ayupo ,
- Dominic Ogwal,
- Dennis Kakaire ,
- Patience Atumanya ,
- Betty Khainza,
- Hajara Nakayiza,
- Hawa Nakandi,
- Kenneth Tomanya,
- Martha Alupo ,
- Lameck Ssemogerere ,
- Erasmus Okello,
- Aggrey Lubikire ,
- Andrew Kintu ,
- Innocent Nyeko ,
- Andrew Kamau ,
- Chamira Kodippily ,
- Arthur Kwizera ,
- ,
- Abigail Beane ,
- Rashan Haniffa ,
- Jorge Ibrain Figueira Salluh
Views280ABSTRACT
Objective
To identify modifiable intensive care unit factors associated with outcomes among patients receiving invasive mechanical ventilation in a low-income setting.
Methods
This prospective, multicenter, registry-embedded observational study has two components: a prospective registry-based cohort assessing patient- and care-process-related factors and a cross-sectional intensive care unit survey evaluating organizational structure. Functional intensive care units in Uganda will be included. Patients aged ≥ 15 years old requiring invasive mechanical ventilation will be enrolled. Patients extubated within 48 hours, transferred after > 24 hours, and imminent early death will be excluded. Primary outcomes will include 28-day intensive care unit mortality, intensive care unit length of stay, and mechanical ventilation duration. Tracheostomy-related outcomes will be explored in a pre-planned sub-study. Factors potentially associated with outcomes will be categorized into non-modifiable and potentially modifiable factors. Non-modifiable factors will include patient-related factors like age, comorbidities, and illness severity; potentially modifiable factors include processes of care (e.g., sedation levels) and intensive care unit organizational structure (e.g., staffing patterns). Multilevel multivariable logistic regression models will assess association outcomes. Survival analysis (Kaplan-Meier curves) will explore mortality trends. Confounders will be identified using directed acyclic graphs.
Results (anticipated findings)
This study will generate high-quality data on modifiable intensive care unit factors associated with ventilated patient outcomes in low-resource settings.
Conclusion
This is Uganda’s first registry-embedded, multicenter intensive care unit study to systematically potentially modifiable factors associated with ventilated patient outcomes. This study will provide evidence-based insights to optimize critical care management in low- and middle-income countries by leveraging real-time intensive care unit registry data.
Keywords:critical careDeveloping countriesintensive care unitsLength of stayRegistriesRespiration, artificialRoutinely collected health dataSurvival analysistracheostomyUgandaSee more
- Cornelius Sendagire
-
Narrative Review08-18-2025
The PROtective VEntilation (PROVE) Network – advancing research and collaboration in mechanical ventilation
- Marcus J. Schultz ,
- Lorenzo Ball ,
- Martin Bernardi ,
- Denise Battaglini ,
- Laura A. Buiteman , [ ... ],
- Jakob Wittenstein
Abstract
Narrative ReviewThe PROtective VEntilation (PROVE) Network – advancing research and collaboration in mechanical ventilation
Critical Care Science. 2025;37:e20250399
DOI 10.62675/2965-2774.20250399
- Marcus J. Schultz ,
- Lorenzo Ball ,
- Martin Bernardi ,
- Denise Battaglini ,
- Laura A. Buiteman ,
- Juliana Carvalho Ferreira ,
- Marcelo Gama de Abreu ,
- Silvia De Rosa ,
- Sabrine N. Hemmes ,
- Robert Huhle ,
- Guido Mazzinari ,
- David M.P. van Meenen ,
- Prashant Nasa ,
- Ary Serpa Neto ,
- Paolo Pelosi ,
- Frederique Paulus ,
- Chiara Robba ,
- Patricia R. M. Rocco ,
- Martin Scharffenberg ,
- Edda Tschernko ,
- Jakob Wittenstein
Views292ABSTRACT
The PROtective VEntilation (PROVE) Network is a globally-recognized collaborative research group dedicated to advancing research, education, and collaboration in the field of mechanical ventilation. Established to address critical questions in intraoperative and intensive care ventilation, the network focuses on improving outcomes for patients undergoing mechanical ventilation in diverse settings, including operating rooms, intensive care units, burn units, and resource-limited environments in low- and middle-income countries. The PROVE Network is committed to generating high-quality evidence through a comprehensive portfolio of investigations, including randomized clinical trials, observational research, and meta-analyses. Its work has significantly contributed to understanding optimal ventilation strategies in critically ill patients, such as those with COVID-19, and in exploring innovative approaches like closed-loop ventilation systems. The network has spearheaded pioneering studies that have shaped clinical practice worldwide by integrating expertise from a wide range of disciplines. A defining feature of the PROVE Network is its emphasis on mentorship and collaboration. It fosters a supportive environment where junior researchers are guided by experienced mentors, ensuring the transfer of knowledge and promoting inclusivity. The network prioritizes gender balance and diversity, recognizing the value of varied perspectives in driving meaningful innovation and advancing research excellence. This paper reviews the history, key projects, and leadership of the PROVE Network, highlighting its impactful contributions to the field of mechanical ventilation. By uniting researchers globally, the PROVE Network exemplifies the power of collaboration in addressing complex clinical challenges, including personalized ventilation and the use of Artificial Intelligence, and improving patient care.
Keywords:Artificial intelligenceCooperative behaviorcritical careDeveloping countriesInnovationintensive care unitsLeadershipMentorsNetworkOperating roomsResearchRespiration, artificialSee moreViews292Abstract
Narrative ReviewThe PROtective VEntilation (PROVE) Network – advancing research and collaboration in mechanical ventilation
Critical Care Science. 2025;37:e20250399
DOI 10.62675/2965-2774.20250399
- Marcus J. Schultz ,
- Lorenzo Ball ,
- Martin Bernardi ,
- Denise Battaglini ,
- Laura A. Buiteman ,
- Juliana Carvalho Ferreira ,
- Marcelo Gama de Abreu ,
- Silvia De Rosa ,
- Sabrine N. Hemmes ,
- Robert Huhle ,
- Guido Mazzinari ,
- David M.P. van Meenen ,
- Prashant Nasa ,
- Ary Serpa Neto ,
- Paolo Pelosi ,
- Frederique Paulus ,
- Chiara Robba ,
- Patricia R. M. Rocco ,
- Martin Scharffenberg ,
- Edda Tschernko ,
- Jakob Wittenstein
Views292ABSTRACT
The PROtective VEntilation (PROVE) Network is a globally-recognized collaborative research group dedicated to advancing research, education, and collaboration in the field of mechanical ventilation. Established to address critical questions in intraoperative and intensive care ventilation, the network focuses on improving outcomes for patients undergoing mechanical ventilation in diverse settings, including operating rooms, intensive care units, burn units, and resource-limited environments in low- and middle-income countries. The PROVE Network is committed to generating high-quality evidence through a comprehensive portfolio of investigations, including randomized clinical trials, observational research, and meta-analyses. Its work has significantly contributed to understanding optimal ventilation strategies in critically ill patients, such as those with COVID-19, and in exploring innovative approaches like closed-loop ventilation systems. The network has spearheaded pioneering studies that have shaped clinical practice worldwide by integrating expertise from a wide range of disciplines. A defining feature of the PROVE Network is its emphasis on mentorship and collaboration. It fosters a supportive environment where junior researchers are guided by experienced mentors, ensuring the transfer of knowledge and promoting inclusivity. The network prioritizes gender balance and diversity, recognizing the value of varied perspectives in driving meaningful innovation and advancing research excellence. This paper reviews the history, key projects, and leadership of the PROVE Network, highlighting its impactful contributions to the field of mechanical ventilation. By uniting researchers globally, the PROVE Network exemplifies the power of collaboration in addressing complex clinical challenges, including personalized ventilation and the use of Artificial Intelligence, and improving patient care.
Keywords:Artificial intelligenceCooperative behaviorcritical careDeveloping countriesInnovationintensive care unitsLeadershipMentorsNetworkOperating roomsResearchRespiration, artificialSee more
- Marcus J. Schultz
-
Original Article07-30-2025
VENTIlatory strategies for patients with severe traumatic brain injury in the LOw- and Middle-Income CountrieS. The VENTILOMICS survey
- Hemanshu Prabhakar ,
- Charu Mahajan ,
- Indu Kapoor ,
- Gentle S. Shrestha ,
- Edoardo Picetti , [ ... ],
- Mani Kalaivani
Abstract
Original ArticleVENTIlatory strategies for patients with severe traumatic brain injury in the LOw- and Middle-Income CountrieS. The VENTILOMICS survey
Critical Care Science. 2025;37:e20250062
DOI 10.62675/2965-2774.20250062
- Hemanshu Prabhakar ,
- Charu Mahajan ,
- Indu Kapoor ,
- Gentle S. Shrestha ,
- Edoardo Picetti ,
- Chiara Robba ,
- Marcus J. Schultz ,
- Mani Kalaivani
Views245ABSTRACT
Objective
To revisit the VENTIlatory Strategies for Patients with Severe Traumatic Brain Injury (VENTILO) survey, focusing on ventilatory management practices among healthcare professionals in low- and middle-income countries.
Methodology
A cross-sectional on-line survey, VENTIlatory strategies for patients with severe traumatic brain injury in the LOw- and Middle-Income CountrieS (VENTILOMICS), was conducted using the original VENTILO survey questionnaire, developed following a review of literature on respiratory management in traumatic brain injury patients, captured demographics of participants, type of hospital/specialty and available neuromonitoring tools; protocols for mechanical ventilation and weaning, and respiratory management strategies. Descriptive statistics were computed for all study variables. We analyzed data based on the economic status of the low- and middle-income countries.
Results
There were 204 respondents from 28 low- and middle-income countries. Our results indicate that 55 - 70% of respondents recommend tidal volumes of 6 - 8mL/kg for patients with high or medium partial pressure of arterial oxygen/inspired fraction of oxygen, while tidal volumes of 4 - 6mL/kg is preferred for those with low partial pressure of arterial oxygen/inspired fraction of oxygen ratios. For patients with intracranial hypertension, lower positive end-expiratory pressure levels were utilized.
Conclusion
The findings suggest a consistent approach to lung-protective ventilation across low-and middle-income countries, with notable variations influenced by local resources and economic status. This study highlights the necessity for tailored research and guidelines to address the specific challenges faced in traumatic brain injury management within low-and middle-income countries.
Keywords:Brain injury, traumaticcritical careDeveloping countriesEconomic statusInternationalityRespiration, artificialSurvey and questionnairesSee moreViews245Abstract
Original ArticleVENTIlatory strategies for patients with severe traumatic brain injury in the LOw- and Middle-Income CountrieS. The VENTILOMICS survey
Critical Care Science. 2025;37:e20250062
DOI 10.62675/2965-2774.20250062
- Hemanshu Prabhakar ,
- Charu Mahajan ,
- Indu Kapoor ,
- Gentle S. Shrestha ,
- Edoardo Picetti ,
- Chiara Robba ,
- Marcus J. Schultz ,
- Mani Kalaivani
Views245ABSTRACT
Objective
To revisit the VENTIlatory Strategies for Patients with Severe Traumatic Brain Injury (VENTILO) survey, focusing on ventilatory management practices among healthcare professionals in low- and middle-income countries.
Methodology
A cross-sectional on-line survey, VENTIlatory strategies for patients with severe traumatic brain injury in the LOw- and Middle-Income CountrieS (VENTILOMICS), was conducted using the original VENTILO survey questionnaire, developed following a review of literature on respiratory management in traumatic brain injury patients, captured demographics of participants, type of hospital/specialty and available neuromonitoring tools; protocols for mechanical ventilation and weaning, and respiratory management strategies. Descriptive statistics were computed for all study variables. We analyzed data based on the economic status of the low- and middle-income countries.
Results
There were 204 respondents from 28 low- and middle-income countries. Our results indicate that 55 - 70% of respondents recommend tidal volumes of 6 - 8mL/kg for patients with high or medium partial pressure of arterial oxygen/inspired fraction of oxygen, while tidal volumes of 4 - 6mL/kg is preferred for those with low partial pressure of arterial oxygen/inspired fraction of oxygen ratios. For patients with intracranial hypertension, lower positive end-expiratory pressure levels were utilized.
Conclusion
The findings suggest a consistent approach to lung-protective ventilation across low-and middle-income countries, with notable variations influenced by local resources and economic status. This study highlights the necessity for tailored research and guidelines to address the specific challenges faced in traumatic brain injury management within low-and middle-income countries.
Keywords:Brain injury, traumaticcritical careDeveloping countriesEconomic statusInternationalityRespiration, artificialSurvey and questionnairesSee more
- Hemanshu Prabhakar
-
Narrative Review06-04-2025
Brazilian Research in Intensive Care Network (BRICNet): shaping the landscape of critical care research in Brazil and beyond
- Juliana Carvalho Ferreira ,
- Adriano José Pereira ,
- Alexandre Biasi Cavalcanti ,
- Antonio Paulo Nassar Junior ,
- Ary Serpa Neto , [ ... ],
- Jorge Ibrain Figueira Salluh
Abstract
Narrative ReviewBrazilian Research in Intensive Care Network (BRICNet): shaping the landscape of critical care research in Brazil and beyond
Critical Care Science. 2025;37:e20250284
DOI 10.62675/2965-2774.20250284
- Juliana Carvalho Ferreira ,
- Adriano José Pereira ,
- Alexandre Biasi Cavalcanti ,
- Antonio Paulo Nassar Junior ,
- Ary Serpa Neto ,
- Bruno Adler Maccagnan Pinheiro Besen ,
- Bruno Martins Tomazini ,
- Cassiano Teixeira ,
- Felipe Dal-Pizzol ,
- Fernando Augusto Bozza ,
- Fernando Godinho Zampieri ,
- Flávia Ribeiro Machado ,
- Glauco Adrieno Westphal ,
- Israel Silva Maia ,
- Leandro Utino Taniguchi ,
- Luciano Cesar Pontes Azevedo ,
- Marcio Soares ,
- Otavio Ranzani ,
- Pedro Vitale Mendes ,
- Rafael Barberena Moraes ,
- Regis Goulart Rosa ,
- Rodrigo Santos Biondi ,
- Suzana Margarete Lobo ,
- Thiago Costa Lisboa ,
- Viviane Cordeiro Veiga ,
- Wagner Luis Nedel ,
- Jorge Ibrain Figueira Salluh
Views840ABSTRACT
Critical illnesses such as sepsis and acute respiratory distress syndrome lead to millions of deaths globally, with a higher burden in low- and middle-income countries. Conducting multicentric clinical studies is essential to help minimize the burden of critical illnesses, particularly in areas where their impact is greater. However, conducting large-scale multicentric studies is challenging, and most large multicentric studies in critical care are from high-income countries, which limits their relevance in other contexts. This highlights the need for collaborative research networks in low- and middle-income countries to better address local needs. The Brazilian Research in Intensive Care Network (BRICNet) was created by a group of intensivists and researchers in 2007 and is dedicated to being the leading organization in Brazil for conducting collaborative clinical research to improve care for critically ill patients. BRICNet focuses on investigator-initiated and collaborative studies relevant to global intensive care, with a special emphasis on Brazilian context. Its mission includes advancing research methodology, scientific writing, and conducting large-scale multicenter studies to fill knowledge gaps in critical care. Since its creation, the network has published 71 articles, including 15 randomized controlled trials and 14 observational studies, many of them in collaboration with major Brazilian institutions and international networks. This review aims to critically assess the achievements of BRICNet, highlighting its high-impact publications, international partnerships, and capacity building, which have significantly contributed to the field of intensive care. Looking ahead, we also identify barriers and solutions for sustainable growth.
Keywords:Brazilcritical carecritical illnessDeveloping countriesGlobal healthResearch designSustainable growthSee moreViews840Abstract
Narrative ReviewBrazilian Research in Intensive Care Network (BRICNet): shaping the landscape of critical care research in Brazil and beyond
Critical Care Science. 2025;37:e20250284
DOI 10.62675/2965-2774.20250284
- Juliana Carvalho Ferreira ,
- Adriano José Pereira ,
- Alexandre Biasi Cavalcanti ,
- Antonio Paulo Nassar Junior ,
- Ary Serpa Neto ,
- Bruno Adler Maccagnan Pinheiro Besen ,
- Bruno Martins Tomazini ,
- Cassiano Teixeira ,
- Felipe Dal-Pizzol ,
- Fernando Augusto Bozza ,
- Fernando Godinho Zampieri ,
- Flávia Ribeiro Machado ,
- Glauco Adrieno Westphal ,
- Israel Silva Maia ,
- Leandro Utino Taniguchi ,
- Luciano Cesar Pontes Azevedo ,
- Marcio Soares ,
- Otavio Ranzani ,
- Pedro Vitale Mendes ,
- Rafael Barberena Moraes ,
- Regis Goulart Rosa ,
- Rodrigo Santos Biondi ,
- Suzana Margarete Lobo ,
- Thiago Costa Lisboa ,
- Viviane Cordeiro Veiga ,
- Wagner Luis Nedel ,
- Jorge Ibrain Figueira Salluh
Views840ABSTRACT
Critical illnesses such as sepsis and acute respiratory distress syndrome lead to millions of deaths globally, with a higher burden in low- and middle-income countries. Conducting multicentric clinical studies is essential to help minimize the burden of critical illnesses, particularly in areas where their impact is greater. However, conducting large-scale multicentric studies is challenging, and most large multicentric studies in critical care are from high-income countries, which limits their relevance in other contexts. This highlights the need for collaborative research networks in low- and middle-income countries to better address local needs. The Brazilian Research in Intensive Care Network (BRICNet) was created by a group of intensivists and researchers in 2007 and is dedicated to being the leading organization in Brazil for conducting collaborative clinical research to improve care for critically ill patients. BRICNet focuses on investigator-initiated and collaborative studies relevant to global intensive care, with a special emphasis on Brazilian context. Its mission includes advancing research methodology, scientific writing, and conducting large-scale multicenter studies to fill knowledge gaps in critical care. Since its creation, the network has published 71 articles, including 15 randomized controlled trials and 14 observational studies, many of them in collaboration with major Brazilian institutions and international networks. This review aims to critically assess the achievements of BRICNet, highlighting its high-impact publications, international partnerships, and capacity building, which have significantly contributed to the field of intensive care. Looking ahead, we also identify barriers and solutions for sustainable growth.
Keywords:Brazilcritical carecritical illnessDeveloping countriesGlobal healthResearch designSustainable growthSee more
- Juliana Carvalho Ferreira
-
Original Article05-30-2019
Availability of resources to treat sepsis in Brazil: a random sample of Brazilian institutions
Revista Brasileira de Terapia Intensiva. 2019;31(2):193-201
Abstract
Original ArticleAvailability of resources to treat sepsis in Brazil: a random sample of Brazilian institutions
Revista Brasileira de Terapia Intensiva. 2019;31(2):193-201
DOI 10.5935/0103-507X.20190033
Views337ABSTRACT
Objective:
To characterize resource availability from a nationally representative random sample of intensive care units in Brazil.
Methods:
A structured online survey of participating units in the Sepsis PREvalence Assessment Database (SPREAD) study, a nationwide 1-day point prevalence survey to assess the burden of sepsis in Brazil, was sent to the medical director of each unit.
Results:
A representative sample of 277 of the 317 invited units responded to the resources survey. Most of the hospitals had fewer than 500 beds (94.6%) with a median of 14 beds in the intensive care unit. Providing care for public-insured patients was the main source of income in two-thirds of the surveyed units. Own microbiology laboratory was not available for 26.8% of the surveyed intensive care units, and 10.5% did not always have access to blood cultures. Broad spectrum antibiotics were not always available in 10.5% of surveyed units, and 21.3% could not always measure lactate within three hours. Those institutions with a high resource availability (158 units, 57%) were usually larger and preferentially served patients from the private health system compared to institutions without high resource availability. Otherwise, those without high resource availability did not always have broad-spectrum antibiotics (24.4%), vasopressors (4.2%) or crystalloids (7.6%).
Conclusion:
Our study indicates that a relevant number of units cannot perform basic monitoring and therapeutic interventions in septic patients. Our results highlight major opportunities for improvement to adhere to simple but effective interventions in Brazil.
Keywords:Brazil/epidemiologycritical careDeveloping countriesEpidemiological monitoringHealth resourcesintensive care unitsSepsis/epidemiologyTherapeuticsSee moreViews337Abstract
Original ArticleAvailability of resources to treat sepsis in Brazil: a random sample of Brazilian institutions
Revista Brasileira de Terapia Intensiva. 2019;31(2):193-201
DOI 10.5935/0103-507X.20190033
Views337ABSTRACT
Objective:
To characterize resource availability from a nationally representative random sample of intensive care units in Brazil.
Methods:
A structured online survey of participating units in the Sepsis PREvalence Assessment Database (SPREAD) study, a nationwide 1-day point prevalence survey to assess the burden of sepsis in Brazil, was sent to the medical director of each unit.
Results:
A representative sample of 277 of the 317 invited units responded to the resources survey. Most of the hospitals had fewer than 500 beds (94.6%) with a median of 14 beds in the intensive care unit. Providing care for public-insured patients was the main source of income in two-thirds of the surveyed units. Own microbiology laboratory was not available for 26.8% of the surveyed intensive care units, and 10.5% did not always have access to blood cultures. Broad spectrum antibiotics were not always available in 10.5% of surveyed units, and 21.3% could not always measure lactate within three hours. Those institutions with a high resource availability (158 units, 57%) were usually larger and preferentially served patients from the private health system compared to institutions without high resource availability. Otherwise, those without high resource availability did not always have broad-spectrum antibiotics (24.4%), vasopressors (4.2%) or crystalloids (7.6%).
Conclusion:
Our study indicates that a relevant number of units cannot perform basic monitoring and therapeutic interventions in septic patients. Our results highlight major opportunities for improvement to adhere to simple but effective interventions in Brazil.
Keywords:Brazil/epidemiologycritical careDeveloping countriesEpidemiological monitoringHealth resourcesintensive care unitsSepsis/epidemiologyTherapeuticsSee more
Developing countries Archives - Critical Care Science (CCS)
