Sepsis is life-threatening organ dysfunction due to a dysregulated host response to infection. A Global Burden of Disease Study indicates that 48.9 million people are affected by sepsis and 11.0 million of them die annually worldwide. In Japan, 470,000 sepsis incidence and 96,000 sepsis-associated deaths are estimated annually. Sepsis incidence and mortality are higher in the resource-limited regions.
In order to improve sepsis management, prevention, early recognition, prompt treatment, and rehabilitation and long-term support of the survivors are the key elements. Those key elements are stated in the Sepsis Declaration by Global Sepsis Alliance in 2012, which was updated in 2020. In the sepsis management, several guidelines have been published. Most common one internationally is Surviving Sepsis Campaign Guidelines (SSCG). Japan has also its own guidelines, which was published in 2012 first, then updated every 4 years thereafter. SSCG was initially focused on the management in the resource-rich environment, but now also focusing on the use in the resource-limited. There are many challenges in adopting those guidelines in the resource-limited, including lack of epidemiology information, different pathogens from the resource-rich regions, failure of the protocols from the resource-rich, and different medical systems including manpower and accessibility to the healthcare facilities.