Details

Autor(en) / Beteiligte

• Kayambankadzanja, Raphael Kazidule
• Schell, Carl Otto
• Mbingwani, Isaac
• Mndolo, Samson Kwazizira
• Castegren, Markus
• Baker, Tim
• Chen, Tai-Heng

Titel

Unmet need of essential treatments for critical illness in Malawi

Ist Teil von

• PloS one, 2021-09, Vol.16 (9), p.e0256361-e0256361

Ort / Verlag

San Francisco: Public Library of Science

Erscheinungsjahr

2021

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Critical illness is common throughout the world and has been the focus of a dramatic increase in attention during the COVID-19 pandemic. Severely deranged vital signs such as hypoxia, hypotension and low conscious level can identify critical illness. These vital signs are simple to check and treatments that aim to correct derangements are established, basic and low-cost. The aim of the study was to estimate the unmet need of such essential treatments for severely deranged vital signs in all adults admitted to hospitals in Malawi. We conducted a point prevalence cross-sectional study of adult hospitalized patients in Malawi. All in-patients aged [greater than or equal to]18 on single days Queen Elizabeth Central Hospital (QECH) and Chiradzulu District Hospital (CDH) were screened. Patients with hypoxia (oxygen saturation <90%), hypotension (systolic blood pressure <90mmHg) and reduced conscious level (Glasgow Coma Scale <9) were included in the study. The a-priori defined essential treatments were oxygen therapy for hypoxia, intravenous fluid for hypotension and an action to protect the airway for reduced consciousness (placing the patient in the lateral position, insertion of an oro-pharyngeal airway or endo-tracheal tube or manual airway protection). Of the 1135 hospital in-patients screened, 45 (4.0%) had hypoxia, 103 (9.1%) had hypotension, and 17 (1.5%) had a reduced conscious level. Of those with hypoxia, 40 were not receiving oxygen (88.9%). Of those with hypotension, 94 were not receiving intravenous fluids (91.3%). Of those with a reduced conscious level, nine were not receiving an action to protect the airway (53.0%). There was a large unmet need of essential treatments for critical illness in two hospitals in Malawi.