Department of Anesthesiology, Weill Cornell Medicine, 1300 York Avenue, Room A-1050, NY, 10065, New York, USA.
Department of Population Health Sciences, Division of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, NY, USA.
BMC Anesthesiol. 2022 Jul 7;22(1):209. doi: 10.1186/s12871-022-01752-z.
The coronavirus-2019 (COVID-19) pandemic highlighted the unfortunate reality that many hospitals have insufficient intensive care unit (ICU) capacity to meet massive, unanticipated increases in demand. To drastically increase ICU capacity, NewYork-Presbyterian/Weill Cornell Medical Center modified its existing operating rooms and post-anaesthesia care units during the initial expansion phase to accommodate the surge of critically ill patients.
This retrospective chart review examined patient care in non-standard Expansion ICUs as compared to standard ICUs. We compared clinical data between the two settings to determine whether the expeditious development and deployment of critical care resources during an evolving medical crisis could provide appropriate care.
Sixty-six patients were admitted to Expansion ICUs from March 1 to April 30, 2020 and 343 were admitted to standard ICUs. Most patients were male (70%), White (30%), 45-64 years old (35%), non-smokers (73%), had hypertension (58%), and were hospitalized for a median of 40 days. For patients that died, there was no difference in treatment management, but the Expansion cohort had a higher median ICU length of stay (q = 0.037) and ventilatory length (q = 0.015). The cohorts had similar rates of discharge to home, but the Expansion ICU cohort had higher rates of discharge to a rehabilitation facility and overall lower mortality.
We found no significantly worse outcomes for the Expansion ICU cohort compared to the standard ICU cohort at our institution during the COVID-19 pandemic, which demonstrates the feasibility of providing safe and effective care for patients in an Expansion ICU.
2019 年冠状病毒病（COVID-19）大流行凸显了一个不幸的现实，即许多医院的重症监护病房（ICU）容量不足，无法满足大量、意外增加的需求。为了大幅增加 ICU 容量，纽约长老会/威尔康奈尔医疗中心在最初的扩张阶段，对现有手术室和麻醉后护理单元进行了改造，以容纳大量重症患者。
本回顾性图表研究比较了非标准扩展 ICU 与标准 ICU 中的患者护理情况。我们比较了两种环境下的临床数据，以确定在不断发展的医疗危机中，快速开发和部署重症监护资源是否能够提供适当的护理。
2020 年 3 月 1 日至 4 月 30 日，66 名患者被收治到扩展 ICU，343 名患者被收治到标准 ICU。大多数患者为男性（70%）、白人（30%）、45-64 岁（35%）、不吸烟（73%）、患有高血压（58%），住院中位数为 40 天。对于死亡患者，治疗管理无差异，但扩展组 ICU 住院时间中位数（q=0.037）和通气时间中位数（q=0.015）更长。两组出院回家的比例相似，但扩展 ICU 组出院到康复机构的比例更高，总体死亡率更低。
在 COVID-19 大流行期间，我们发现与标准 ICU 组相比，我们机构的扩展 ICU 组的结果没有明显恶化，这表明在扩展 ICU 中为患者提供安全有效的护理是可行的。
