#Healthcare #infrastructure #capacity to respond to severe acute respiratory infection (#SARI) and #sepsis in #Vietnam: A low-middle income country (J Crit Care., abstract)

[Source: Science Direct, full page: (LINK). Abstract, edited.]

Journal of Critical Care / Available online 10 July 2017 / In Press, Accepted Manuscript

Healthcare infrastructure capacity to respond to severe acute respiratory infection (SARI) and sepsis in Vietnam: A low-middle income country

Dat Vu Quoc a, b, Long Nguyen Thanh a, Kim Bao Giang c, Pham Bich Diep c, Ta Hoang Giang c, Janet V. Diaz d

a Department of Infectious Diseases, Hanoi Medical University, No 1 Ton That Tung Street, Dong Da District, Hanoi, Vietnam; b Intensive Care Unit, National Hospital for Tropical Diseases, 78 Giai Phong Street, Dong Da District, Hanoi, Vietnam; c Institute of Preventive Medicine and Public Health, Hanoi Medical University, No 1 Ton That Tung street, Dong Da District, Hanoi, Vietnam; d California Pacific Medical Center, Castro St & Duboce Ave, San Francisco, CA 94114, USA.

Available online 10 July 2017 / https://doi.org/10.1016/j.jcrc.2017.07.020

 

Highlights

  • Most hospitals have basic staffing, equipment and supplies to provide critical care services but that international standards cannot be met consistently due to lack of some key resources.
  • A major limitation in critical care units was the lack of particulate respirators (N95) necessary to implement airborne precautions.
  • There is a need to establish an essential list of equipment and supplies to better prepare ICUs for future pandemics or outbreaks of infectious threats.

 

Abstract

Purpose

This study investigated the availability of relevant structural and human resources needed for the clinical management of patients with severe acute respiratory infections and sepsis in critical care units in Vietnam.

Material and methods

A questionnaire survey was conducted by purposive sampling of 128 hospitals (36% of total hospitals in surveyed provinces), including 25 provincial and 103 district level hospitals, from 20 provinces in Vietnam. Data on availability of hospital characteristics, structural resources and health care workers was then analyzed.

Results

Most hospitals (> 80%) reported having 60% of the relevant structural resources. Significant differences were observed between provincial hospitals when compared to district hospitals in regards to availability of central oxygen piping system (78.3% vs 38.7%, p = 0.001) mechanical ventilation (100.0% vs 73.6%, p = 0.003), mobile x-rays (80.0% vs 29.8%, p < 0.001), carbapenem antibiotic (73.9% vs 17.4%, p < 0.001) and norepinephrine (95.8% vs 56.3%, p < 0.001). There was a limited availability of arterial blood gas analyzers (13.7%), oseltamivir (42.2%) and N95 respirators (54.6%) across all hospitals surveyed.

Conclusions

The limited availability of relevant structural and human resources in critical care units around Vietnam makes the implementation of quality critical care to patients with SARI and sepsis, according international guidelines, not universally possible.

Abbreviations: CCU, critical care unit; RLS, resource-limited setting; SARI, severe acute respiratory infection; WHO, World Health Organization

Keywords: Severe respiratory infection; Sepsis; ICU capacity; Healthcare infrastructure; Low-middle income country

Keywords: SARI; Sepsis; Vietnam.

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Giuseppe Michieli

I am an Italian blogger, active since 2005 with main focus on emerging infectious diseases such as avian influenza, SARS, antibiotics resistance, and many other global Health issues. Other fields of interest are: climate change, global warming, geological and biological sciences. My activity consists mainly in collection and analysis of news, public services updates, confronting sources and making decision about what are the 'signals' of an impending crisis (an outbreak, for example). When a signal is detected, I follow traces during the entire course of an event. I started in 2005 my blog ''A TIME'S MEMORY'', now with more than 40,000 posts and 3 millions of web interactions. Subsequently I added an Italian Language blog, then discontinued because of very low traffic and interest. I contributed for seven years to a public forum (FluTrackers.com) in the midst of the Ebola epidemic in West Africa in 2014, I left the site to continue alone my data tracking job.