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Beating Sepsis in South America: What are the challenges?

A Summary by Flavia Machado:

Beating sepsis in Latin America is a challenge.

There are 5 major issues.

First, we badly know our enemy. There are few papers coming from our continent and most of them are low quality epidemiological studies, with only a couple about quality improvement initiatives. In Brazil, some recent studies showed a critical scenario. In a random selection of 229 Brazilian ICUs the mortality rate was 55.7%.

Another important issue is the availability of resources. In this study, based on a score of 8 items considered necessary to care for septic patients, about 30% of the institutions from the poorest region of Brazil were considered as having low availability, which means having five or less of these items.

There is also an important inequality in ICU access. The number of ICUs bed in the public system is 7.6 per 100,000 habitants while there are 25.5 beds per 100,000 habitants covered by the private system.

The quality in process of care also varies between these two types of systems. In the Latin America Sepsis Institute database, now with almost 30,000 patients coming from institutions that have implemented sepsis protocols based on the SSC bundles, a reduction in mortality occurred only in those from the private system. This difference is even more impressive among those patients with sepsis in the emergence department.

Another major issue is the low awareness both among the healthcare team and lay people. A recent survey conducted in 134 cities including more than 2000 Brazilians showed that less than 7% of them have ever heard the word sepsis.

Raising awareness is the key point as this will also help to get support from the government. Governmental healthcare policies in the sepsis field are needed and they are the most impacting strategy in our settings.

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