The practice of intensive care in Latin America: a survey of academic intensivists

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dc.citation.volume22
dc.contributor.authorCastro, Ricardo
dc.contributor.authorNin, Nicolas
dc.contributor.authorRios, Fernando
dc.contributor.authorAlegria, Leyla
dc.contributor.authorEstenssoro, Elisa
dc.contributor.authorMurias, Gaston
dc.contributor.authorFriedman, Gilberto
dc.contributor.authorJibaja, Manuel
dc.contributor.authorOspina-Tascon, Gustavo
dc.contributor.authorHurtado, Javier
dc.contributor.authordel Carmen Marin, Maria
dc.contributor.authorMachado, Flavia R. [UNIFESP]
dc.contributor.authorCavalcanti, Alexandre Biasi
dc.contributor.authorDubin, Arnaldo
dc.contributor.authorAzevedo, Luciano [UNIFESP]
dc.contributor.authorCecconi, Maurizio
dc.contributor.authorBakker, Jan
dc.contributor.authorHernandez, Glenn
dc.coverageLondon
dc.date.accessioned2020-07-08T13:09:39Z
dc.date.available2020-07-08T13:09:39Z
dc.date.issued2018
dc.description.abstractBackground: Intensive care medicine is a relatively young discipline that has rapidly grown into a full-fledged medical subspecialty. Intensivists are responsible for managing an ever-increasing number of patients with complex, lifethreatening diseases. Several factors may influence their performance, including age, training, experience, workload, and socioeconomic context. The aim of this study was to examine individual-and work-related aspects of the Latin American intensivist workforce, mainly with academic appointments, which might influence the quality of care provided. In consequence, we conducted a cross-sectional study of intensivists at public and private academic and nonacademic Latin American intensive care units (ICUs) through a web-based electronic survey submitted by email. Questions about personal aspects, work-related topics, and general clinical workflow were incorporated. Results: Our study comprised 735 survey respondents (53% return rate) with the following country-specific breakdown: Brazil (29%)en
dc.description.abstractArgentina (19%)en
dc.description.abstractChile (17%)en
dc.description.abstractUruguay (12%)en
dc.description.abstractEcuador (9%)en
dc.description.abstractMexico (7%)en
dc.description.abstractColombia (5%)en
dc.description.abstractand Bolivia, Peru, Guatemala, and Paraguay combined (2%). Latin American intensivists were predominantly male (68%) young adults (median age, 40 [IQR, 35-48] years) with a median clinical ICU experience of 10 (IQR, 5-20) years. The median weekly workload was 60 (IQR, 47-70) h. ICU formal training was between 2 and 4 years. Only 63% of academic ICUs performed multidisciplinary rounds. Most intensivists (85%) reported adequate conditions to manage patients with septic shock in their units. Unsatisfactory conditions were attributed to insufficient technology (11%), laboratory support (5%), imaging resources (5%), and drug shortages (5%). Seventy percent of intensivists participated in research, and 54% read scientific studies regularly, whereas 32% read no more than one scientific study per month. Research grants and pharmaceutical sponsorship are unusual funding sources in Latin America. Although Latin American intensivists are mostly unsatisfied with their income (81%), only a minority (27%) considered changing to another specialty before retirement. Conclusions: Latin American intensivists constitute a predominantly young adult workforce, mostly formally trained, have a high workload, and most are interested in research. They are under important limitations owing to resource constraints and overt dissatisfaction. Latin America may be representative of other world areas with similar challenges for intensivists. Specific initiatives aimed at addressing these situations need to be devised to improve the quality of critical care delivery in Latin America.en
dc.description.affiliationPontificia Univ Catolica Chile, Fac Med, Dept Med Intens, Diagonal Paraguay 362, Santiago Ctr, RM, Chile
dc.description.affiliationHosp Espanol, Ave Gen Garibaldi,1729 Esq, Montevideo, Uruguay
dc.description.affiliationANII, Montevideo, Uruguay
dc.description.affiliationHosp Alejandro Posadas, Serv Terapia Intens, Ave Presidente Arturo U Illia, Buenos Aires, DF, Argentina
dc.description.affiliationHosp Interzonal Agudos Gen San Martin La Plata, Serv Terapia Intens, Ave 1 1794,B1904CFU, La Plata, Buenos Aires, Argentina
dc.description.affiliationClin Bazterr, Billinghurst 2072,Esquina Juncal, Buenos Aires, DF, Argentina
dc.description.affiliationClin Santa Isabel, Billinghurst 2072,Esquina Juncal, Buenos Aires, DF, Argentina
dc.description.affiliationUniv Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Fac Med, Dept Med Interna, Rua Ramiro Barcelos 2350, BR-90035903 Porto Alegre, RS, Brazil
dc.description.affiliationUniv Int Ecuador, Hosp Eugenio Espejo, Unidad Cuidados Intens, Escuela Med, Ave Gran Colombia, Quito 170136, Ecuador
dc.description.affiliationUniv ICESI, Fdn Valle Del Lili, Dept Intens Care Med, Carrera 98 18-49, Cali, Valle Del Cauca, Colombia
dc.description.affiliationHosp Reg 1 Octubre, ISSSTE, Unidad Cuidados Intens, Ave Inst Politecn Nacl 1669, Mexico City 07300, DF, Mexico
dc.description.affiliationUniv Fed Sao Paulo, Anesthesiol Pain & Intens Care Dept, Rua Sena Madureira 1500, BR-04021001 Sao Paulo, SP, Brazil
dc.description.affiliationHosp Coracao, Res Inst HCor, Rua Desembargador Eliseu Guilherme 147, BR-04004030 Sao Paulo, SP, Brazil
dc.description.affiliationUniv Nacl La Plata, Fac Ciencias Med, Catedra Farmacol, Buenos Aires, DF, Argentina
dc.description.affiliationSanatorio Otamendi & Miroli, Serv Terapia Intens, Azcuenaga 894,C1115AAB, Buenos Aires, DF, Argentina
dc.description.affiliationUniv Fed Sao Paulo, Anesthesiol Pain & Intens Care Dept, Sao Paulo, SP, Brazil
dc.description.affiliationUniv Sao Paulo, Hosp Sirio Libanes, Emergency Med Dept, Rua Dona Adma Jafet 91, BR-01308050 Sao Paulo, SP, Brazil
dc.description.affiliationSt Georges Univ Hosp NHS Fdn Trust, London SW17 0QT, England
dc.description.affiliationColumbia Univ, Med Ctr, Div Pulm Allergy & Crit Care Med, 630 West 168th St, New York, NY 10032 USA
dc.description.affiliationUC CHRISTUS, Hosp Clin, Unidad Paciente Crit Adultos, Marcoleta 367, Santiago Ctr 8330077, RM, Chile
dc.description.affiliationUnifespUniv Fed Sao Paulo, Anesthesiol Pain & Intens Care Dept, Rua Sena Madureira 1500, BR-04021001 Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Anesthesiol Pain & Intens Care Dept, Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1186/s13054-018-1956-6
dc.identifier.citationCritical Care. London, v. 22, p. -, 2018.
dc.identifier.doi10.1186/s13054-018-1956-6
dc.identifier.fileWOS000426388900002.pdf
dc.identifier.issn1466-609X
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/54114
dc.identifier.wosWOS:000426388900002
dc.language.isoeng
dc.publisherBiomed Central Ltd
dc.relation.ispartofCritical Care
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectIntensive care unitsen
dc.subjectLatin Americanen
dc.subjectLMICen
dc.subjectCritical careen
dc.subjectHealthen
dc.subjectManpoweren
dc.titleThe practice of intensive care in Latin America: a survey of academic intensivistsen
dc.typeinfo:eu-repo/semantics/article
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