Since its launch in 2022, the Mount Sinai Global Critical Care Program has established international partnerships with hospitals outside of La Paz, Bolivia, and Dhulilkhel, Nepal. We approach collaborations with three main goals: 1.) Education and capacity building, 2.) system adoption of best practices, and 3.) research focusing on clinical questions relevant to the local population. In the realm of education, Mount Sinai faculty and fellows have conducted workshops on the use of bedside ultrasound, in-situ critical care simulations, and education on percutaneous tracheostomy placement, as well as delivered didactic lectures on a range of critical care topics. We have worked with nurses and physicians to develop protocols for daily spontaneous awakening and breathing trials, appropriate sedation algorithms, and explored ways to improve critical care response in the emergency room and hospital wards where recognizing and responding to severe illness quickly is essential. As we move forward, our teams continue to work together to streamline the collection of clinical data to answer research questions about the provision of critical care in resource-challenged environments that have largely been ignored in the scientific literature so far.

Despite breathtaking advances in medical technology over the last half-century, the distribution of healthcare resources today remains uneven. Low- and middle-income countries continue to experience a disproportionate burden of disability and death related not only to infectious diseases largely eradicated in developed countries, but also that related to non-communicable diseases such as cardiovascular disease, cancer, and trauma. As a result, the poorest billion people on the planet bear a burden of disability adjusted life years (DALYs) that is 44% greater than that suffered by the richest. In Low- and Middle-Income Countries (LMICs) there remain gaping deficiencies in access to emergency care, prompt surgical services, and intensive care that need to be strengthened to reduce suffering and save lives. Responding to this need, the Institute of Critical Care Medicine at Mount Sinai developed the Global Critical Care Program to support and advance intensive care in communities in need around the world.