Arjen M. Dondorp - Sepsis Management in Resource-limited Settings

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It is a great honour to be writing the foreword for the first edition of Sepsis Management in Resource-Limited Settings .

The publication of this book could not be more timely; lives will be saved if the advice and wisdom of the authors of this superb book is translated into everyday clinical care in all settings around the world. Over the last decade, it has become increasingly clear that we can dramatically improve the survival chances of patients with sepsis and other critical care conditions. The key is the earlier identification and initial management and then the continued care of patients and their families. What we do really matters and can make the difference between life and death. It has also become apparent that this is not just the role of doctors, but increasingly paramedics, nurses, pharmacists, other healthcare professionals, and families all have a critical role to play.

This book, authored by people all looking after patients with sepsis today, is inspiring; a brilliant summary of what is known, how to best apply what is known wherever you work; and a pleasure to read whatever your personal experience or qualifications. It will be as useful to someone at the start of their career and will enhance the work of someone with many years of experience. A book for everyone, everywhere.

I cannot commend the authors highly enough, for taking complex, sometimes frightening, issues and making them understandable and accessible. I learnt a huge amount by reading it (after a career of over 30 years) and will make sure to carry it with me. This book will have a tremendous impact on the lives of many people around the worldthank you.

I would like to congratulate and praise all the contributing authors and the Global Intensive Care working group of the European Society of Intensive Care Medicine and the Mahidol Oxford Tropical Medicine Unit in Bangkok for the initiative of writing this book and the result achieved. Sepsis is a very complex syndrome already defined ages ago in various ways. Today, even with advanced medical facilities, the mortality of patients with sepsis remains high. Most of the worlds population live in low- and middle-income countries, and they usually have a higher mortality due to sepsis. Next to this, many standard sepsis treatments developed in high-income countries may not be directly applicable in low- and middle-income countries. This could be due to factors such as lack of recognition, medicine, equipment, and access to intensive care and preventive measures. This book provides an in-depth understanding of these issues and applicable treatment alternatives for sepsis patients in low- and middle-income countries.

I feel very privileged to contribute this foreword for this very precious work.

Soon after the concept of sepsis had been described, research unveiled the enormous burden sepsis puts on patients, society, and healthcare services. However, most research came from high-income countries, and it inadvertently suggested that sepsis was primarily a disease condition encountered in emergency departments and intensive care units in North America, Europe, and Australasia. Over time it became apparent that the true epidemic of sepsis had so far gone unnoticed. Annually, millions of deaths due to acute severe infections, and by extension to sepsis, occurred in low- and lower- to middle-income countries without much acknowledgment in the medical literature. Furthermore, this biased view on the topic had falsely shaped our understanding of sepsis. Based on epidemiological studies from high-income countries, sepsis was largely regarded as a life-threatening complication of bacterial and sometimes fungal infection. On a global scale, however, viruses, protozoans, and