Critical Care Management in Resource-Limited Settings
Summary
Critical care management in resource-limited settings centres on delivering life-saving interventions despite constraints in infrastructure, staffing and equipment. In many low- and middle-income contexts, severely ill patients are managed outside conventional intensive care units, with generalist clinicians employing simplified protocols and essential therapies. Fundamental elements include early recognition of critical illness, standardised triage systems and implementation of Essential Emergency and Critical Care (EECC)—a package of low-cost, high-impact measures such as oxygen therapy, fluid resuscitation and basic monitoring. Task-shifting and targeted training of nurses and non-physician clinicians can compensate for specialist shortages, while quality improvement programmes foster adherence to clinical bundles and reduce mortality. The COVID-19 pandemic highlighted the fragility of oxygen supply chains and the importance of maintenance and procurement frameworks for concentrators and ventilators. Sustainable improvements require government commitment to health system strengthening, investment in context-specific research and regional collaboration to adapt guidelines to local epidemiology and resource availability. By integrating digital tools, fostering multidisciplinary teamwork and embedding critical care fundamentals into universal health coverage, hospitals can markedly improve outcomes for the critically ill in constrained environments.
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Critical Care Management in Resource-Limited Settings publication trend
The graph below shows the total number of articles in critical care management in resource-limited settings across all publications each year (not limited to Nature Index journals).
Technical terms
Essential Emergency and Critical Care (EECC): A defined package of low-complexity, low-cost interventions for identifying and managing critically ill patients in all hospitals.
Triage: The process of prioritising patients for treatment based on severity of illness and urgency of care needed.
Sepsis: A life-threatening organ dysfunction caused by a dysregulated host response to infection.
Mechanical ventilation: The use of a machine to assist or replace spontaneous breathing in patients with respiratory failure.
Oxygen concentrator: A device that extracts and delivers concentrated oxygen from ambient air for therapeutic use.
Quality improvement programme: A structured initiative to analyse clinical processes and implement changes that enhance patient outcomes and safety.
References
- Global critical care: a call to action. Critical Care (2023).
- Implementation of Smart Triage combined with a quality improvement program for children presenting to facilities in Kenya and Uganda: An interrupted time series analysis. PLOS Digital Health (2025).
- Hospital care for critical illness in low-resource settings: lessons learned during the COVID-19 pandemic. BMJ Global Health (2023).
- Essential Emergency and Critical Care: a consensus among global clinical experts. BMJ Global Health (2021).
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