Ferrer Ricard, Báguena Marcelino, Balcells Joan, Bañeras Jordi, Biarnes Alfons, de Nadal Miriam, Gracia Rosa María, Martinez Jesús, Nuvials Xavier, Riera Jordi, Roca Oriol, Ruiz-Rodriguez Juan Carlos
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.
Servicio de Medicina Intensiva. Hospital Universitario de Traumatología, Rehabilitación y Quemados Vall d'Hebron, Barcelona, España.
Enferm Infecc Microbiol Clin (Engl Ed). 2020 Sep 8;40(2):71-7. doi: 10.1016/j.eimc.2020.08.007.
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.
在病毒社区传播的背景下，这场大流行对医疗保健系统，主要是对重症监护病房（ICU）的影响预计将是毁灭性的。瓦尔德希伯伦大学医院（HUVH）实施了前所未有的危重症患者护理规划和资源管理。
我们描述了巴塞罗那HUVH在大流行的头两个月（从2020年3月3日至2020年5月2日）的一组重症患者。在本手稿中，我们报告了我们的预测、实施的策略以及取得的结果。
3033名患者被收治到HUVH重症监护病房。在整个研究期间，接受有创机械通气（IMV）或IMV及体外膜肺氧合（ECMO）治疗的患者比例保持在78%以上。大多数患者为男性（65%）；最常见的年龄组为60 - 70岁。23名患者接受了ECMO治疗，其中18名在另一个中心插管后转至HUVH。研究结束时，14名患者成功拔管，3名患者死亡，其余患者仍在接受ECMO治疗。8名孕妇在ICU接受了治疗，生存率为100%。60岁以下患者的ICU死亡率为3.2%。幸存者和非幸存者的平均ICU住院时间均为14天。
为危重症患者护理进行资源扩充的充分准备、主要挑战以及总体积极结果可为未来类似情况提供借鉴。
