Planning for the assistance of critically ill patients in a Pandemic Situation: The experience of Vall d'Hebron University Hospital.

Organización de la atención a pacientes críticos en situación de pandemia: Experiencia del Hospital Vall d’Hebron durante el brote de neumonía por SARS-CoV-2.
Acute respiratory distress syndrome COVID-19 Coronavirus Distrés respiratorio Health-care system Hospital resources ICU Recursos hospitalarios Sistema sanitario UCI

Journal

Enfermedades infecciosas y microbiologia clinica (English ed.)
ISSN: 2529-993X
Titre abrégé: Enferm Infecc Microbiol Clin (Engl Ed)
Pays: Spain
ID NLM: 101777541

Informations de publication

Date de publication:
08 Sep 2020
Historique:
received: 22 05 2020
revised: 04 08 2020
accepted: 09 08 2020
entrez: 4 10 2020
pubmed: 5 10 2020
medline: 5 10 2020
Statut: aheadofprint

Résumé

In the context of community transmission of the virus, the impact of the pandemic on health-care systems, mainly on intensive care units (ICU), was expected to be devastating. Vall d́Hebron University Hospital (HUVH) implemented an unprecedented critical patient-care planning and management of resources. We describe a cohort of critically ill patients during the first two months of the pandemic (from March 3, 2020, to May 2, 2020) in HUVH, Barcelona. In this manuscript, we report our previsions, strategies implemented, and the outcomes obtained. Three-thousand and thirty-three patients were admitted to the HUVH Critical Care Units. Throughout the study period, the proportion of patients on IMV or IMV and ECMO remained above 78%. Most patients were men (65%); the most common age group was 60-70 years. Twenty-three patients received ECMO, and eighteen were cannulated at another center and transferred to HUVH. At the end of the study, fourteen patients were successfully decannulated, three patients died, and the rest of the patients were still on ECMO. Eight pregnant women have been treated in the ICU, with a survival rate of 100%. The ICU mortality of patients younger than 60 years was 3.2%. The mean ICU stay of both survivors and nonsurvivors was 14 days. The adequate preparation for resource expansion for critically ill patients care, main challenges, and overall positive results can serve as a precedent for similar future scenarios.

Identifiants

pubmed: 33010961
pii: S0213-005X(20)30272-X
doi: 10.1016/j.eimc.2020.08.007
pmc: PMC7834691
pii:
doi:

Types de publication

Journal Article

Langues

eng spa

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2020 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Publicado por Elsevier España, S.L.U. All rights reserved.

Références

Med Intensiva (Engl Ed). 2020 Oct;44(7):439-445
pubmed: 32402532
JAMA. 2020 Apr 28;323(16):1574-1581
pubmed: 32250385
Med Intensiva (Engl Ed). 2020 Aug - Sep;44(6):363-370
pubmed: 32336551
N Engl J Med. 2020 May 21;382(21):2049-2055
pubmed: 32202722
JAMA. 2020 May 26;323(20):2052-2059
pubmed: 32320003
Med Intensiva (Engl Ed). 2020 Aug - Sep;44(6):323-324
pubmed: 32376091

Auteurs

Ricard Ferrer (R)

Servicio de Medicina Intensiva. Hospital Universitario Vall d'Hebron. Sepsis Organ Dysfunction and Resuscitation (SODIR) Research group. Vall d'Hebron Institut de Recerca (VHIR). Universidad Autónoma de Barcelona (UAB), Barcelona, España. Electronic address: r.ferrer@vhebron.net.

Marcelino Báguena (M)

Servicio de Medicina Intensiva. Hospital Universitario de Traumatología, Rehabilitación y Quemados Vall d'Hebron, Barcelona, España.

Joan Balcells (J)

Unidad de Cuidados Intensivos Pediátricos. Hospital Universitario Vall d'Hebron. Universidad Autónoma de Barcelona , Barcelona, España.

Jordi Bañeras (J)

Acute Cardiovascular Care Unit, Department of Cardiology, Centre de Simulació Clínica Avançada VHISCA, Vall d'Hebron Hospital, Universidad Autónoma de Barcelona. CIBERCV, Barcelona, España.

Alfons Biarnes (A)

Servicio de Anestesiología y Reanimación. Hospital Universitario Vall d'Hebron, Barcelona, España.

Miriam de Nadal (M)

Servicio de Anestesiología y Reanimación. Hospital Universitario Vall d'Hebron, Barcelona, España.

Rosa María Gracia (RM)

Servicio de Medicina Intensiva. Hospital Universitario Vall d'Hebron. Sepsis Organ Dysfunction and Resuscitation (SODIR) Research group. Vall d'Hebron Institut de Recerca (VHIR). Universidad Autónoma de Barcelona (UAB), Barcelona, España.

Jesús Martinez (J)

Coordinador de críticos. Hospital Universitario Vall d'Hebron, Barcelona, España.

Xavier Nuvials (X)

Servicio de Medicina Intensiva. Hospital Universitario Vall d'Hebron. Sepsis Organ Dysfunction and Resuscitation (SODIR) Research group. Vall d'Hebron Institut de Recerca (VHIR). Universidad Autónoma de Barcelona (UAB), Barcelona, España.

Jordi Riera (J)

Servicio de Medicina Intensiva. Hospital Universitario Vall d'Hebron. Sepsis Organ Dysfunction and Resuscitation (SODIR) Research group. Vall d'Hebron Institut de Recerca (VHIR). Universidad Autónoma de Barcelona (UAB), Barcelona, España.

Oriol Roca (O)

Servicio de Medicina Intensiva. Hospital Universitario Vall d'Hebron. Sepsis Organ Dysfunction and Resuscitation (SODIR) Research group. Vall d'Hebron Institut de Recerca (VHIR). Universidad Autónoma de Barcelona (UAB), Barcelona, España.

Juan Carlos Ruiz-Rodriguez (JC)

Servicio de Medicina Intensiva. Hospital Universitario Vall d'Hebron. Sepsis Organ Dysfunction and Resuscitation (SODIR) Research group. Vall d'Hebron Institut de Recerca (VHIR). Universidad Autónoma de Barcelona (UAB), Barcelona, España.

Classifications MeSH