Sepsis in vulnerable populations

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Public Health

Background:

• Sepsis pathogenesis is complex, lacking a clear pathophysiological link between cause and effect.
• Host immune responses in sepsis paradoxically hinder disease progression while causing multiorgan dysfunction.
• Inconsistent clinical features complicate sepsis diagnosis and management.

Purpose of the Study:

• To highlight the limitations of current sepsis definitions and management guidelines.
• To address the ineffectiveness of the Surviving Sepsis Guidelines (SSG) in low- and middle-income countries (LMICs).
• To advocate for the development of locally relevant and adaptable sepsis care strategies.

Main Methods:

• Comprehensive review of existing sepsis literature and clinical guidelines.
• Analysis of challenges in applying global guidelines to resource-limited settings.
• Identification of factors hindering effective sepsis care in vulnerable populations.

Main Results:

• Current sepsis definitions lack a unifying pathophysiological description.
• The Surviving Sepsis Guidelines (SSG) are not universally applicable due to regional differences in sepsis etiology, disease burden, and resource availability.
• LMICs face significant barriers including limited infrastructure, human capacity, and socioeconomic factors impacting sepsis care.

Conclusions:

• There is a critical need for improved understanding of sepsis pathophysiology.
• Global sepsis guidelines require adaptation to be effective in diverse socioeconomic and healthcare contexts.
• Future sepsis care strategies must incorporate local realities and be informed by region-specific data for vulnerable populations.