Wiesner B, Bachmann M, Blum T-G, Forchheim S, Geiseler J, Kassin A, Kretzschmar E, Weber-Carstens S, Westhoff M, Witzenrath M, Grohé C
Evangelische Lungenklinik, Berlin.
Asklepios Klinikum Harburg, Zentrum für Atemwegs- und Thoraxmedizin.
Pneumologie. 2020 Jun;74(6):358-365. doi: 10.1055/a-1153-9710. Epub 2020 Apr 15.
The enormous increase in patients with severe respiratory distress due to the COVID-19 pandemic outbreak requires a systematic approach to optimize ventilated patient at risk flow. A standardised algorithm called "SAVE" was developed to distribute patients with COVID-19 respiratory distress syndrome requiring invasive ventilation. This program is established by now in Berlin. An instrumental bottleneck of this approach is the vacant slot assignment in the intensive care unit to guarantee constant patient flow. The transfer of the patients after acute care treatment is needed urgently to facilitate the weaning process. In a next step we developed a triage algorithm to identify patients at SAVE intensive care units with potential to wean and transfer to weaning institutions - we called POST SAVE. This manuscript highlights the algorithms including the use of a standardised digital evaluation tool, the use of trained navigators to facilitate the communication between SAVE intensive care units and weaning institutions and the establishment of a prospective data registry for patient assignment and reevaluation of the weaning potential in the future.
由于新冠疫情爆发，严重呼吸窘迫患者数量大幅增加，这就需要一种系统的方法来优化有风险的通气患者流程。一种名为“SAVE”的标准化算法被开发出来，用于分配需要有创通气的新冠呼吸窘迫综合征患者。该项目目前已在柏林建立。这种方法的一个关键瓶颈是重症监护病房的空位分配，以确保患者流量稳定。急性护理治疗后患者的转移迫在眉睫，以促进脱机过程。下一步，我们开发了一种分诊算法，以识别SAVE重症监护病房中有脱机潜力并可转移至脱机机构的患者——我们称之为POST SAVE。本文重点介绍了这些算法，包括使用标准化数字评估工具、利用经过培训的导航员促进SAVE重症监护病房与脱机机构之间的沟通，以及建立前瞻性数据登记系统，用于患者分配和未来脱机潜力的重新评估。
