Department of Intensive Care, Ministry of National Guard Health Affairs, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
Curr Opin Crit Care. 2022 Dec 1;28(6):638-644. doi: 10.1097/MCC.0000000000001001. Epub 2022 Oct 11.
The coronavirus disease 2019 (COVID-19) pandemic has posed great challenges to intensive care units (ICUs) across the globe. The objective of this review is to provide an overview on how ICU surging was managed during COVID-19 pandemic, with a special focus on papers published in the last 18 months.
From the onset of the COVID-19 pandemic, it was apparent that the biggest challenge was the inequity of access to an adequately equipped and staffed ICU bed. The first wave was overwhelming; large surge of patients required critical care, resources were limited and non-COVID-19 care processes were severely compromised. Various approaches were used to address ICU staffing shortage and to expand the physical ICU space capacity. Because of restrictions to family visitations in most ICUs, the pandemic posed a threat to communication and family-centered ICU care. The pandemic, especially during the first wave, was accompanied by a high level of apprehension in the community, many uncertainties about clinical course and therapy and an influx of speculations and misinformation.
Although healthcare systems learned how to face some of the challenges with subsequent waves, the pandemic had persistent effects on healthcare systems.
2019 年冠状病毒病(COVID-19)大流行给全球各重症监护病房(ICU)带来了巨大挑战。本文旨在概述 COVID-19 大流行期间 ICU 扩充管理情况,重点关注过去 18 个月发表的文献。
从 COVID-19 大流行开始,显而易见的最大挑战是获得配备有足够设备和人员的 ICU 床位的机会不平等。第一波疫情汹涌而至;大量患者需要重症护理,资源有限,非 COVID-19 护理流程严重受损。为解决 ICU 人员短缺和扩大 ICU 物理空间容量,采用了各种方法。由于大多数 ICU 限制家属探视,大流行对沟通和以家庭为中心的 ICU 护理构成威胁。大流行,尤其是在第一波疫情期间,引起了社区的高度关注,对临床病程和治疗存在诸多不确定性,并涌入了大量猜测和错误信息。
尽管医疗保健系统在后续浪潮中学会了如何应对一些挑战,但大流行对医疗保健系统仍有持续影响。