A national healthcare response to intensive care bed requirements during the COVID-19 outbreak in France.


Journal

Anaesthesia, critical care & pain medicine
ISSN: 2352-5568
Titre abrégé: Anaesth Crit Care Pain Med
Pays: France
ID NLM: 101652401

Informations de publication

Date de publication:
Dec 2020
Historique:
received: 25 09 2020
accepted: 25 09 2020
pubmed: 9 10 2020
medline: 29 12 2020
entrez: 8 10 2020
Statut: ppublish

Résumé

Whereas 5415 Intensive Care Unit (ICU) beds were initially available, 7148 COVID-19 patients were hospitalised in the ICU at the peak of the outbreak. The present study reports how the French Health Care system created temporary ICU beds to avoid being overwhelmed. All French ICUs were contacted for answering a questionnaire focusing on the available beds and health care providers before and during the outbreak. Among 336 institutions with ICUs before the outbreak, 315 (94%) participated, covering 5054/5531 (91%) ICU beds. During the outbreak, 4806 new ICU beds (+95% increase) were created from Acute Care Unit (ACU, 2283), Post Anaesthetic Care Unit and Operating Theatre (PACU & OT, 1522), other units (374) or real build-up of new ICU beds (627), respectively. At the peak of the outbreak, 9860, 1982 and 3089 ICU, ACU and PACU beds were made available. Before the outbreak, 3548 physicians (2224 critical care anaesthesiologists, 898 intensivists and 275 from other specialties, 151 paediatrics), 1785 residents, 11,023 nurses and 6763 nursing auxiliaries worked in established ICUs. During the outbreak, 2524 physicians, 715 residents, 7722 nurses and 3043 nursing auxiliaries supplemented the usual staff in all ICUs. A total number of 3212 new ventilators were added to the 5997 initially available in ICU. During the COVID-19 outbreak, the French Health Care system created 4806 ICU beds (+95% increase from baseline), essentially by transforming beds from ACUs and PACUs. Collaboration between intensivists, critical care anaesthesiologists, emergency physicians as well as the mobilisation of nursing staff were primordial in this context.

Sections du résumé

BACKGROUND BACKGROUND
Whereas 5415 Intensive Care Unit (ICU) beds were initially available, 7148 COVID-19 patients were hospitalised in the ICU at the peak of the outbreak. The present study reports how the French Health Care system created temporary ICU beds to avoid being overwhelmed.
METHODS METHODS
All French ICUs were contacted for answering a questionnaire focusing on the available beds and health care providers before and during the outbreak.
RESULTS RESULTS
Among 336 institutions with ICUs before the outbreak, 315 (94%) participated, covering 5054/5531 (91%) ICU beds. During the outbreak, 4806 new ICU beds (+95% increase) were created from Acute Care Unit (ACU, 2283), Post Anaesthetic Care Unit and Operating Theatre (PACU & OT, 1522), other units (374) or real build-up of new ICU beds (627), respectively. At the peak of the outbreak, 9860, 1982 and 3089 ICU, ACU and PACU beds were made available. Before the outbreak, 3548 physicians (2224 critical care anaesthesiologists, 898 intensivists and 275 from other specialties, 151 paediatrics), 1785 residents, 11,023 nurses and 6763 nursing auxiliaries worked in established ICUs. During the outbreak, 2524 physicians, 715 residents, 7722 nurses and 3043 nursing auxiliaries supplemented the usual staff in all ICUs. A total number of 3212 new ventilators were added to the 5997 initially available in ICU.
CONCLUSION CONCLUSIONS
During the COVID-19 outbreak, the French Health Care system created 4806 ICU beds (+95% increase from baseline), essentially by transforming beds from ACUs and PACUs. Collaboration between intensivists, critical care anaesthesiologists, emergency physicians as well as the mobilisation of nursing staff were primordial in this context.

Identifiants

pubmed: 33031979
pii: S2352-5568(20)30216-2
doi: 10.1016/j.accpm.2020.09.007
pmc: PMC7534597
pii:
doi:

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

709-715

Informations de copyright

Copyright © 2020 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

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Auteurs

Jean-Yves Lefrant (JY)

EA 2992 IMAGINE, Univ Montpellier, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Nîmes, France. Electronic address: jean.yves.lefrant@chu-nimes.fr.

Marc-Olivier Fischer (MO)

Normandie Univ, UNICAEN, CHU de Caen Normandie, Service d'Anesthésie Réanimation, 14000 Caen, France.

Hugo Potier (H)

Laboratoire de Biostatistique, Epidémiologie clinique, Santé Publique Innovation et Méthodologie (BESPIM), Pôle Pharmacie, Santé publique, CHU Nîmes, Nîmes, University of Montpellier, France.

Cécile Degryse (C)

Service d'Anesthésie Réanimation Pellegrin Tripode, CHU Bordeaux, Bordeaux, France.

Samir Jaber (S)

Department of Anaesthesia & Critical Care Medicine, University of Montpellier Saint Eloi Hospital, and PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.

Laurent Muller (L)

EA 2992 IMAGINE, Univ Montpellier, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Nîmes, France.

Julien Pottecher (J)

Hôpitaux Universitaires de Strasbourg, Pôle d'Anesthésie-Réanimation & Médecine Péri-Opératoire, Service d'Anesthésie-Réanimation & Médecine Péri-Opératoire Hôpital de Hautepierre - Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), UR3072, Strasbourg, France.

Hélène Charboneau (H)

Service d'Anesthésie, Clinique Pasteur, 31300 Toulouse, France.

Eric Meaudre (E)

Fédération d'Anesthésie-Réanimation, Hôpital d'Instruction des Armées Sainte-Anne, Toulon; Chaire d'Anesthésie-réanimation, Médecine d'Urgence, École du Val-de-Grâce, Paris, France.

Pierre Lanot (P)

GARHPA, groupe de anesthésistes réanimateurs de l'Hôpital Privé d'Antony, 92160 Antony, France.

Vincent Bruckert (V)

Pôle d'Anesthésie-Réanimation Médecine péri-opératoire et Urgences, Hôpital l'Archet 2, Centre Hospitalier Universitaire de Nice, Université de Nice, 06000 Nice, France.

Benoît Plaud (B)

Paris University & APHP. Nord. DMU PARABOL, Department of Anaesthesiology, Critical Care & Burn Unit, Saint-Louis hospital, 1, Avenue Claude Vellefaux, 75010 Paris, France.

Bertrand Dureuil (B)

Departement of Anaesthesia and Critical Care, Rouen University Hospital, Rouen, France.

Emmanuel Samain (E)

Département d'Anesthésie Réanimation, Hôpital Jean Minjoz - C.H.U. de Besançon, Besançon, France.

Hervé Bouaziz (H)

Département d'Anesthésie Réanimation, Hôpital Central - CHRU Nancy, Nancy, France.

Claude Ecoffey (C)

Département d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Hôpital Pontchaillou, Université Rennes 1, Rennes, France.

Xavier Capdevila (X)

Department of Anaesthesiology and Critical Care Medicine, Lapeyronie University Hospital and Montpellier University. INSERM unit 1051, Montpellier Neurosciences Institute, Montpellier, France.

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