International, but for whom? Pediatric sepsis guidelines and the limits of global applicability

Abstract

Most children who die from sepsis live in low- and middle-income countries (LMICs), yet international pediatric sepsis guidelines are largely derived from evidence generated in high-income intensive care settings. This creates a fundamental tension between global standardization of care and unequal health system capacity. Interventions shown to be effective in well-resourced hospitals may not be feasible, safe, or beneficial in settings with limited monitoring, staffing, and critical care infrastructure.