Department of Anaesthesia and Intensive Care, Viborg Regional Hospital, Viborg, Denmark.
Prehospital Emergency Medical Services, Central Denmark Region, Aarhus, Denmark.
Acta Anaesthesiol Scand. 2022 Aug;66(7):859-868. doi: 10.1111/aas.14094. Epub 2022 Jun 9.
The COVID-19 pandemic has caused a shortage of intensive care resources. Intensivists' opinion of triage and ventilator allocation during the COVID-19 pandemic is not well described.
This was a survey concerning patient numbers, bed capacity, triage guidelines, and three virtual cases involving ventilator allocations. Physicians from 400 ICUs in a research network were invited to participate. Preferences were assessed with a five-point Likert scale. Additionally, age, gender, work experience, geography, and religion were recorded.
Of 437 responders 31% were female. The mean age was 44.4 (SD 11.1) with a mean ICU experience of 13.7 (SD 10.5) years. Respondents were mostly European (88%). Sixty-six percent had triage guidelines available. Younger patients and caretakers of children were favoured for ventilator allocation although this was less clear if this involved withdrawal of the ventilator from another patient. Decisions did not differ with ICU experience, gender, religion, or guideline availability. Consultation of colleagues or an ethical committee decreased with age and male gender.
Intensivists appeared to prioritise younger patients for ventilator allocation. The tendency to consult colleagues about triage decreased with age and male gender. Many found such tasks to be not purely medical and that authorities should assume responsibility for triage during resource scarcity.
COVID-19 大流行导致重症监护资源短缺。重症监护医师在 COVID-19 大流行期间对分类和呼吸机分配的看法尚未得到充分描述。
这是一项关于患者数量、床位容量、分类指南以及涉及呼吸机分配的三个虚拟病例的调查。邀请了来自研究网络中 400 个 ICU 的医生参与。使用五点李克特量表评估偏好。此外，还记录了年龄、性别、工作经验、地理位置和宗教信仰。
在 437 名应答者中，31%为女性。平均年龄为 44.4（SD 11.1），平均 ICU 经验为 13.7（SD 10.5）年。受访者主要来自欧洲（88%）。66%有分类指南。年轻患者和儿童看护者更倾向于呼吸机分配，尽管如果这涉及从另一名患者撤下呼吸机，情况就不太清楚了。决策与 ICU 经验、性别、宗教或指南可用性无关。随着年龄的增长和男性性别，与同事协商或伦理委员会的咨询减少。
重症监护医师似乎更倾向于为呼吸机分配年轻患者。随着年龄的增长和男性性别，咨询同事进行分类的倾向降低。许多人认为这些任务不仅仅是医学问题，当局应在资源匮乏时承担分类的责任。
