De Santo Luca Salvatore, Rubino Antonino Salvatore, Torella Michele, Galbiati Denise, Iannelli Gabriele, Iesu Severino, Tritto Francesco Paolo, Fiorani Brenno, Chiariello Luigi, De Bellis Antonio, Di Benedetto Giuseppe, Zebele Carlo, De Feo Marisa
Cardiac Surgery Unit, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", AORN dei Colli, Cardiac Surgery, Vincenzo Monaldi Hospital, Naples, Italy.
Department of Advanced Biomedical Sciences, Cardiac Surgery Unit, University of Naples Federico II, Policlinico Federico II, Naples, Italy.
J Thorac Dis. 2021 Jan;13(1):125-132. doi: 10.21037/jtd-20-2298.
Health systems worldwide have been overburdened by the "COVID-19 surge". Consequently, strategies to remodulate non-COVID medical and surgical care had to be developed. Knowledge of the impact of COVID surge on cardiac surgery practice is mainstem. Present study aims to evaluate the regional practice pattern during lockdown in Campania.
A multicenter regional observational 26-question survey was conducted, including all adult cardiac surgery units in Campania, Italy, to assess how surgical practice has changed during COVID-19 national lockdown.
All centers adopted specific protocols for screening patients and personnel. A significant reduction in the number of dedicated intensive care unit (ICU) beds (-30.0%±38.1%, range: 0-100%) and cardiac operating rooms (-22.2%±26.4%, range: 0-50%) along with personnel relocation to other departments was disclosed (anesthesiologists -5.8%±11.1%, range: 0-33.3%; perfusionists -5.6%±16.7%, range: 0-50%; nurses -4.8%±13.2%, range: 0-40%; cardiologists -3.2%±9.5%, range: 0-28.6%). Cardiac surgeons were never reallocated to other services. Globally, we witnessed dramatically lower adult cardiac surgery case volumes (335 667 procedures, P<0.001), as institutions and surgeons followed guidelines to curtail non-urgent operations.
This regional survey demonstrates major changes in practice as a response to the COVID-19 pandemic. In this respect, this experience might lead to the development of permanent systems-based plans for future pandemic and may effectively help policy decision making when prioritizing healthcare resource reallocation during and after the pandemic.
全球卫生系统因“新冠疫情高峰”而不堪重负。因此，必须制定重新调整非新冠医疗和外科护理的策略。了解新冠疫情高峰对心脏外科手术实践的影响至关重要。本研究旨在评估坎帕尼亚地区封锁期间的区域实践模式。
开展了一项多中心区域观察性调查，该调查有26个问题，涵盖意大利坎帕尼亚地区所有成人心脏外科手术单位，以评估在新冠疫情全国封锁期间手术实践是如何变化的。
所有中心都采用了筛查患者和工作人员的特定方案。结果显示，专用重症监护病房（ICU）床位数量显著减少（-30.0%±38.1%，范围：0-100%），心脏手术室数量减少（-22.2%±26.4%，范围：0-50%），同时人员被重新分配到其他科室（麻醉医生-5.8%±11.1%，范围：0-33.3%；灌注师-5.6%±16.7%，范围：0-50%；护士-4.8%±13.2%，范围：0-40%；心脏病专家-3.2%±9.5%，范围：0-28.6%）。心脏外科医生从未被重新分配到其他服务岗位。总体而言，我们看到成人心脏手术病例数量大幅下降（335至667例手术，P<0.001），因为机构和外科医生遵循指南减少了非紧急手术。
这项区域调查表明，作为对新冠疫情的应对措施，实践发生了重大变化。在这方面，这一经验可能会促使制定基于系统的永久性未来大流行应对计划，并可能在大流行期间及之后优先进行医疗资源重新分配时有效帮助政策决策。
