Caring for COVID-19 patients through a pandemic in the intensive care setting: A narrative review.
COVID-19
critical care
planning
surge capacity
training
Journal
WIREs mechanisms of disease
ISSN: 2692-9368
Titre abrégé: WIREs Mech Dis
Pays: United States
ID NLM: 9918227353306676
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
revised:
20
05
2022
received:
30
01
2022
accepted:
23
06
2022
pubmed:
15
7
2022
medline:
15
11
2022
entrez:
14
7
2022
Statut:
ppublish
Résumé
Since the declaration of the novel SARS-CoV-2 virus pandemic, health systems/ health-care-workers globally have been overwhelmed by a vast number of COVID-19 related hospitalizations and intensive care unit (ICU) admissions. During the early stages of the pandemic, the lack of formalized evidence-based guidelines in all aspects of patient management was a significant challenge. Coupled with a lack of effective pharmacotherapies resulted in unsatisfactory outcomes in ICU patients. The anticipated increment in ICU surge capacity was staggering, with almost every ICU worldwide being advised to increase their capacity to allow adequate care provision in response to multiple waves of the pandemic. This increase in surge capacity required advanced planning and reassessments at every stage, taking advantage of experienced gained in combination with emerging evidence. In University Hospital Southampton General Intensive Care Unit (GICU), despite the initial lack of national and international guidance, we enhanced our ICU capacity and developed local guidance on all aspects of care to address the rapid demand from the increasing COVID-19 admissions. The main element of this success was a multidisciplinary team approach intertwined with equipment and infrastructural reorganization. This narrative review provides an insight into the approach adopted by our center to manage patients with COVID-19 critical illness, exploring the initial planning process, including contingency preparations to accommodate (360% capacity increment) and adaptation of our management pathways as more evidence emerged throughout the pandemic to provide the most appropriate levels of care to our patients. We hope our experience will benefit other intensive care units worldwide. This article is categorized under: Infectious Diseases > Genetics/Genomics/Epigenetics.
Identifiants
pubmed: 35835688
doi: 10.1002/wsbm.1577
pmc: PMC9350295
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1577Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
Brendish, N. J., Poole, S., Naidu, V., Mansbridge, C. T., Norton, N. J., Wheeler, H., Presland, L., Kidd, S., Cortes, N. J., Borca, F., Phan, H., Babbage, G., Visseaux, B., Ewings, S., & Clark, T. W. (2020). Clinical impact of molecular point-of-care testing for suspected COVID-19 in hospital (COV-19POC): A prospective, interventional, non-randomised, controlled study. The Lancet Respiratory Medicine, 8(12), 1192-1200. https://doi.org/10.1016/S2213-2600(20)30454-9
Burke, H., Freeman, A., Cellura, D. C., Stuart, B. L., Brendish, N. J., Poole, S., Borca, F., Phan, H. T. T., Sheard, N., Williams, S., Spalluto, C. M., Staples, K. J., Clark, T. W., Wilkinson, T. M. A., Wilkinson, T., Freeman, A., Burke, H., Dushianthan, A., Celinski, M., … Kipps, C. (2020). Inflammatory phenotyping predicts clinical outcome in COVID-19. Respiratory Research, 21(1), 245. https://doi.org/10.1186/s12931-020-01511-z
Burton-Papp, H. C., Jackson, A. I. R., Beecham, R., Ferrari, M., Nasim-Mohi, M., Grocott, M. P. W., Chambers, R., & Dushianthan, A. (2020). Conscious prone positioning during non-invasive ventilation in COVID-19 patients: Experience from a single Centre. F1000Research, 9: 859. https://doi.org/10.12688/f1000research.25384.1
Cutler, D. M., & Summers, L. H. (2020). The COVID-19 pandemic and the $16 trillion virus. JAMA, 324(15), 1495-1496. https://doi.org/10.1001/jama.2020.19759
Doidge, J. C., Gould, D. W., Ferrando-Vivas, P., Mouncey, P. R., Thomas, K., Shankar-Hari, M., Harrison, D. A., & Rowan, K. M. (2021). Trends in intensive care for patients with covid-19 in England, Wales, and Northern Ireland. American Journal of Respiratory and Critical Care Medicine, 203(5), 565-574. https://doi.org/10.1164/rccm.202008-3212OC
Dushianthan, A., Abdul, N., Dmochowski, J., James, I., Heesom, L., Westwood, J., Effney, J., Bruty, S., Saeed, K., Rangarajan, S., & Kazmi, R. (2021). Predictive role of haematological determinants on outcomes of critically ill COVID-19 patients admitted to intensive care unit. Cureus, 13, e16764. https://doi.org/10.7759/cureus.16764
Dushianthan, A., Cumpstey, A. F., Ferrari, M., Thomas, W., Moonesinghe, S. R., Summers, C., Montgomery, H., & Grocott, M. P. W. (2021). Intensive care physicians' perceptions of the diagnosis & management of patients with acute hypoxic respiratory failure associated with COVID-19: A UK based survey. Journal of the Intensive Care Society. [online first] https://doi.org/10.1177/17511437211002352
Elkington, P. T., Dickinson, A. S., Mavrogordato, M. N., Spencer, D. C., Gillams, R. J., de Grazia, A., Rosini, S., Garay-Baquero, D. J., Diment, L. E., Mahobia, N., Mant, A., Baynham, T., & Morgan, H. (2021). A personal respirator to improve protection for healthcare workers treating COVID-19 (PeRSo). Frontiers in Medical Technology, 3. [online first] https://doi.org/10.3389/fmedt.2021.664259
GOV.UK. (2020). https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control
Guérin, C., Reignier, J., Richard, J.-C., Beuret, P., Gacouin, A., Boulain, T., Mercier, E., Badet, M., Mercat, A., Baudin, O., Clavel, M., Chatellier, D., Jaber, S., Rosselli, S., Mancebo, J., Sirodot, M., Hilbert, G., Bengler, C., Richecoeur, J., … Ayzac, L. (2013). Prone positioning in severe acute respiratory distress syndrome. New England Journal of Medicine, 368(23), 2159-2168. https://doi.org/10.1056/nejmoa1214103
Gupta, S., Coca, S. G., Chan, L., Melamed, M. L., Brenner, S. K., Hayek, S. S., Sutherland, A., Puri, S., Srivastava, A., Leonberg-Yoo, A., Shehata, A. M., Flythe, J. E., Rashidi, A., Schenck, E. J., Goyal, N., Hedayati, S. S., Dy, R., Bansal, A., Athavale, A., Nguyen, H. B., … STOP-COVID Investigators (2021). AKI Treated with Renal Replacement Therapy in Critically Ill Patients with COVID-19. Journal of the American Society of Nephrology: JASN, 32(1), 161-176. https://doi.org/10.1681/ASN.2020060897
Heesom, L., Rehnberg, L., Nasim-Mohi, M., Jackson, A. I. R., Celinski, M., Dushianthan, A., Cook, P., Rivinberg, W., & Saeed, K. (2020). Procalcitonin as an antibiotic stewardship tool in COVID-19 patients in the intensive care. Journal of Global Antimicrobial Resistance, 22, 782-784. https://doi.org/10.1016/j.jgar.2020.07.017
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., … Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 395, 10223.
ICNARC. (2022). https://www.icnarc.org/our-audit/audits/cmp/reports
Intensive Care Society and Faculty of Intensive Care Medicine. (2019). Faculty of intensive care medicine [internet]. Guidance for: Prone positioning in adult critical care. Faculty of Intensive Care Medicine 2019. https://www.ics.ac.uk/ICU/Guidance/PDFs/Prone_Position_Guidance_in_Adult_Critical_Care
Legrand, M., Bell, S., Forni, L., Joannidis, M., Koyner, J. L., Liu, K., & Cantaluppi, V. (2021). Pathophysiology of COVID-19-associated acute kidney injury. In. Nature Reviews Nephrology, 17, 751-764. https://doi.org/10.1038/s41581-021-00452-0
Lowe, R., Ferrari, M., Nasim-Mohi, M., Jackson, A., Beecham, R., Veighey, K., Cusack, R., Richardson, D., Grocott, M., Levett, D. Z. H., Dushianthan, A., Gupta, S., Nixon, J., Stewart, M., Dushianthan, A., Sparkes, D., Chambers, R., Nolan, K., Tanser, S., … Kipps, C. (2021). Clinical characteristics and outcome of critically ill COVID-19 patients with acute kidney injury: A single centre cohort study. BMC Nephrology, 22(1), 92. https://doi.org/10.1186/s12882-021-02296-z
Munro, A., Prieto, J., Mentzakis, E., Dibas, M., Mahobia, N., Baker, P., Herbert, S., Smith, T., Hine, M., Hall, J., McClarren, A., Davidson, M., Brooks, J., Fisher, J., Griffiths, D., Morgan, H., Giulietti, C., Faust, S. N., & Elkington, P. (2021). Powered respirators are effective, sustainable, and cost-effective personal protective equipment for SARS-CoV-2. Frontiers in Medical Technology, 3. [online first] https://doi.org/10.3389/fmedt.2021.729658
National Institute for Health and Care Excellence (NICE). (2020). COVID-19 rapid guideline: antibiotics for pneumonia in adults in hospital. https://www.nice.org.uk/guidance/ng173/chapter/tests-to-guide-decisions-about-using-antibiotics#tests-to-guide-decisions-about-using-antibiotics
Schuetz, P., Beishuizen, A., Broyles, M., Ferrer, R., Gavazzi, G., Gluck, E. H., Gonzalez Del Castillo, J., Jensen, J. U., Kanizsai, P. L., Kwa, A. L. H., Krueger, S., Luyt, C. E., Oppert, M., Plebani, M., Shlyapnikov, S. A., Toccafondi, G., Townsend, J., Welte, T., & Saeed, K. (2019). Procalcitonin (PCT)-guided antibiotic stewardship: An international experts consensus on optimized clinical use. Clinical Chemistry and Laboratory Medicine, 57(9), 1308-1318. https://doi.org/10.1515/cclm-2018-1181
Shahi, A. K., Ahmed-Saeed, N., Taylor, I., Kiernan, S., Mahobia, N., Pelosi, E., & Saeed, K. (2021). Environmental contamination and personal protective equipment contamination with SARS-CoV-2 virus in a real-life clinical setting. Journal of Infection Prevention, 23, 7-10. https://doi.org/10.1177/17571774211033348
Sivaloganathan, A. A., Nasim-Mohi, M., Brown, M. M., Abdul, N., Jackson, A., Fletcher, S., Gupta, S., Grocott, M. P. W., Dushianthan, A., Gupta, S., Nixon, J., Grocott, M. P. W., Levett, D. Z. H., Stewart, M., Dushianthan, A., Sparkes, D., Chambers, R., Nolan, K., Tanser, S., … Kipps, C. (2020). Noninvasive ventilation for COVID-19-associated acute hypoxaemic respiratory failure: Experience from a single centre. British Journal of Anaesthesia, 125(4), e368-e371. https://doi.org/10.1016/j.bja.2020.07.008
Stubbs, M. (2020). UHS proning team [online]. https://uhs.proning.team
WHO. (2022). WHO situation report. https://covid19.who.int/