From the Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, Frankfurt/Main, Germany (EH-A, AF, KZ), Clinic for Anaesthesia and Intensive Therapy, Clinical Center Nis, School of Medicine, University of Nis, Nis, Serbia (RJ) and Department of Anaesthesiology and Perioperative Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium (S-DH).
Eur J Anaesthesiol. 2021 Apr 1;38(4):344-347. doi: 10.1097/EJA.0000000000001423.
In light of the coronavirus disease-2019 (COVID-19) pandemic, how resources are managed and the critically ill are allocated must be reviewed. Although ethical recommendations have been published, strategies for dealing with overcapacity of critical care resources have so far not been addressed.
Assess expert opinion for allocation preferences regarding the growing imbalance between supply and demand for medical resources.
A 10-item questionnaire was developed and sent to the most prominent members of the European Society of Anaesthesiology and Intensive Care (ESAIC).
Survey via a web-based platform.
Respondents were members of the National Anaesthesiologists Societies Committee and Council Members of the ESAIC; 74 of 80 (92.5%), responded to the survey.
Responses were analysed thematically. The majority of respondents (83.8%), indicated that resources for COVID-19 were available at the time of the survey. Of the representatives of the ESAIC governing bodies, 58.9% favoured an allocation of excess critical care capacity: 69% wished to make them available to supraregional patients, whereas 30.9% preferred to keep the resources available for the local population. Regarding the type of distribution of resources, 35.3% preferred to make critical care available, 32.4% favoured the allocation of medical equipment and 32.4% wished to support both options. The majority (59.5%) supported the implementation of a central European institution to manage such resource allocation.
Experts in critical care support the allocation of resources from centres with overcapacity. The results indicate the need for centrally administered allocation mechanisms that are not based on ethically disputable triage systems. It seems, therefore, that there is wide acceptance and solidarity among the European anaesthesiological community that local medical and human pressure should be relieved during a pandemic by implementing national and international re-allocation strategies among healthcare providers and healthcare systems.
鉴于 2019 年冠状病毒病（COVID-19）大流行，必须审查资源管理和危重病患者分配方式。尽管已经发布了伦理建议，但迄今为止尚未解决处理重症监护资源过剩的策略。
评估专家对日益增长的医疗资源供需失衡的分配偏好的意见。
制定了一个包含 10 个问题的问卷，并分发给欧洲麻醉学和重症监护学会（ESAIC）的最杰出成员。
通过网络平台进行调查。
受访者是国家麻醉师协会委员会和 ESAIC 理事会成员；80 名（92.5%）中的 74 名对调查做出了回应。
对回复进行了主题分析。大多数受访者（83.8%）表示，在调查时已经有 COVID-19 的资源。ESAIC 管理机构的代表中，58.9%赞成分配多余的重症监护能力：69%希望将其提供给超区域患者，而 30.9%则希望将资源保留给当地居民。关于资源分配的类型，35.3%赞成提供重症监护，32.4%赞成分配医疗设备，32.4%希望支持这两种选择。大多数人（59.5%）支持建立一个中欧机构来管理这种资源分配。
重症监护专家支持从资源过剩的中心分配资源。结果表明需要有中央管理的分配机制，而不是基于有争议的伦理分诊系统。因此，欧洲麻醉学界似乎广泛接受并团结起来，认为在大流行期间，通过在医疗保健提供者和医疗保健系统之间实施国家和国际重新分配策略，可以缓解当地的医疗和人员压力。
