Department of Anaesthesia, National University Health System, Singapore.
Department of Cardiothoracic and Vascular Surgery, National University Health System, Singapore.
Anaesthesia. 2020 Jul;75(7):861-871. doi: 10.1111/anae.15074. Epub 2020 May 3.
In December 2019, a cluster of atypical pneumonia cases were reported in Wuhan, China, and a novel coronavirus elucidated as the aetiologic agent. Although most initial cases occurred in China, the disease, termed coronavirus disease 2019, has become a pandemic and continues to spread rapidly with human-to-human transmission in many countries. This is the third novel coronavirus outbreak in the last two decades and presents an ensuing healthcare resource burden that threatens to overwhelm available healthcare resources. A study of the initial Chinese response has shown that there is a significant positive association between coronavirus disease 2019 mortality and healthcare resource burden. Based on the Chinese experience, some 19% of coronavirus disease 2019 cases develop severe or critical disease. This results in a need for adequate preparation and mobilisation of critical care resources to anticipate and adapt to a surge in coronavirus disease 2019 case-load in order to mitigate morbidity and mortality. In this article, we discuss some of the peri-operative and critical care resource planning considerations and management strategies employed in a tertiary academic medical centre in Singapore in response to the coronavirus disease 2019 outbreak.
2019 年 12 月,中国武汉报告了一组非典型肺炎病例,一种新型冠状病毒被确定为病因。尽管最初的病例大多发生在中国,但这种疾病被称为 2019 年冠状病毒病,已成为一种大流行,并继续在许多国家迅速传播,人与人之间传播。这是过去二十年中的第三次新型冠状病毒爆发,由此带来的医疗资源负担威胁到现有的医疗资源。对中国最初应对措施的研究表明,2019 年冠状病毒病死亡率与医疗资源负担之间存在显著的正相关关系。根据中国的经验,约 19%的 2019 年冠状病毒病病例会发展为严重或危重症。这就需要充分准备和调动重症监护资源,以应对 2019 年冠状病毒病病例的激增,从而降低发病率和死亡率。在本文中,我们讨论了新加坡一家三级学术医疗中心在应对 2019 年冠状病毒病疫情时所采用的一些围手术期和重症监护资源规划考虑因素和管理策略。