Intensive care in the developing world

Appropriate and sustainable intensive care practice is possible even in the resource-limited locations of sub-Saharan Africa. Data from seven sub-Saharan African countries indicates that the majority of patients served are surgical. Comparison between intensive care units is difficult due to lack of laboratory support, which precludes the severity sickness scores used internationally. Hospital mortality can be reduced by increasing nurse/patient ratios, adequate monitoring and initiating postoperative intermittent positive pressure ventilation when required. Equipment should include appropriate technology, for instance using oxygen concentrators and a ventilator not dependent on compressed gases or disposable circuits. The clinical officer anaesthetist has a major role to play in the intensive care team.