Anaesthesiology and Critical Care Medicine Department, DMU PARABOL, Bichat - Claude Bernard Hospital, HUPNVS, AP-HP, Paris, France.
Réunion Island University, French Institute of Health and Medical Research (INSERM), U1188 Diabetes atherothrombosis Réunion Indian Ocean (DéTROI), CYROI Platform, Saint-Denis, de La Réunion, France.
BMC Anesthesiol. 2022 Oct 3;22(1):310. doi: 10.1186/s12871-022-01845-9.
During the COVID-19 first wave in France, the capacity of intensive care unit (ICU) beds almost doubled, mainly because of the opening of temporary ICUs with staff and equipment from anaesthesia.
We aim to investigate if the initial management in temporary ICU is associated with a change in ICU mortality and short-term prognosis.
Retrospective single-centre cohort study.
Surgical ICU of the Bichat Claude Bernard University Hospital during the COVID-19 "first wave" (from 18 March to 10 April 2020).
All consecutive patients older than 18 years of age with laboratory-confirmed SARS-CoV-2 infection and/or typical radiological patterns were included during their first stay in the ICU for COVID-19.
Patients were admitted to a temporary ICU if no room was available in the classical ICU and if they needed invasive mechanical ventilation but no renal replacement therapy or Extracorporeal Membrane Oxygenation (ECMO) in the short term. The temporary ICUs were managed by mixed teams (from the ICU and anaesthesiology departments) following a common protocol and staff meetings.
ICU mortality RESULTS: Among the 59 patients admitted, 37 (62.7%) patients had initial management in the temporary ICU. They had the same characteristics on admission and the same medical management as patients admitted to the classical ICU. ICU mortality was similar in the 2 groups (32.4% in temporary ICUs versus 40.9% in classical ICUs; p=0.58). SAPS-II and ECMO use were associated with mortality in multivariate analysis but not admission to the temporary ICU.
In an overload context of the ICU of a geographical area, our temporary ICU model allowed access to intensive care for all patients requiring it without endangering them.
在法国 COVID-19 第一波疫情期间，重症监护病房（ICU）床位容量几乎翻了一番，这主要是因为开设了配备麻醉科医护人员和设备的临时 ICU。
我们旨在研究临时 ICU 的初始管理是否与 ICU 死亡率和短期预后的变化有关。
回顾性单中心队列研究。
Bichat-Claude Bernard 大学医院外科 ICU 在 COVID-19“第一波”期间（2020 年 3 月 18 日至 4 月 10 日）。
所有年龄大于 18 岁且实验室确诊为 SARS-CoV-2 感染和/或具有典型放射学特征的患者，在 ICU 首次因 COVID-19 入住期间均被纳入。
如果在经典 ICU 没有床位，且患者需要侵入性机械通气但短期内不需要肾脏替代治疗或体外膜氧合（ECMO），则将患者收治入临时 ICU。临时 ICU 由 ICU 和麻醉科混合团队管理，遵循共同的方案和员工会议。
ICU 死亡率。
在 59 名入住患者中，37 名（62.7%）患者在临时 ICU 接受了初始治疗。他们入院时的特征和接受的医学管理与收治在经典 ICU 的患者相同。两组患者的 ICU 死亡率相似（临时 ICU 组为 32.4%，经典 ICU 组为 40.9%；p=0.58）。SAPS-II 和 ECMO 使用与多变量分析中的死亡率相关，但与入住临时 ICU 无关。
在 ICU 超负荷的地理区域中，我们的临时 ICU 模式允许所有需要重症监护的患者获得治疗，而不会危及他们的生命。
