'Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status.' This is the conclusion of a new paper in The Lancet Global Health. The original studies took place between 2011 and 2018.
CITATION: Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies
Luigi Pisani et al. Published: December 13, 2021 Lancet Global Health
DOI:https://doi.org/10.1016/S2214-109X(21)00485-X
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00485-X/fulltext
SELECTED EXTRACT: 'There is a wide range of potential factors at different levels of the care process that can contribute to the observed higher case fatality of mechanically ventilated patients in MICs. These factors include shortages in human and structural resources in low-income and MICs, limited use of treatment protocols, suboptimal ICU processes organisation, higher prevalence of antimicrobial drug resistance, higher bed-to-nurse ratio, or not having a daily plan of care review in place.'
A linked Comment concludes: 'The authors reveal a more complex issue: the in-hospital and pre-hospital care for acute illnesses in MICs. We hope this spurs the international community to find solutions for an equitable commitment to better care for critically ill patients globally.'
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00522-2/fulltext
Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org
