Parchomchuk Evan, Holt Tanya, Hansen Gregory
College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Jim Pattison Children's Hospital, Saskatoon, SK, Canada.
JMIR Pediatr Parent. 2023 Feb 10;6:e43602. doi: 10.2196/43602.
The COVID-19 pandemic overwhelmed Canadian hospitals with adult admissions. A large number of adult patients required critical care therapies, placing significant strain on hospital resources. In order to decompress adult intensive care units, pediatric intensive care units (PICUs) introduced adapted models of traditional care to lessen these burdens.
We aimed to evaluate how PICUs across Canada adapted care for the high volumes of critically ill adults.
A survey containing 40 questions was sent to the medical directors of 14 Canadian PICUs where English was the primary clinical language. The survey was designed to gain perspective on the various adaptations that PICUs instituted during the COVID-19 pandemic.
Of the 13 PICUs that returned survey responses (response rate: 13/14, 93%), 10 (77%) participated in at least one adaptation to support the influx of admitted adults with COVID-19. The key challenges included disorganization, loss of autonomy, and compromised patient care. The significant advantages of these adaptations included a sense of learning and comradery.
Our study highlighted an unpreparedness in critical care surge capacity. During the COVID-19 pandemic, adaptations rapidly emerged in Canada that involved PICUs with adult care. In the future, preplanned adaptations for optimizing robust critical care services should be developed based on what has been learned from the COVID-19 pandemic.
新冠疫情使加拿大医院收治的成年患者数量剧增。大量成年患者需要重症监护治疗，给医院资源带来了巨大压力。为了减轻成人重症监护病房的负担，儿科重症监护病房（PICU）引入了传统护理的适应性模式。
我们旨在评估加拿大各地的儿科重症监护病房如何为大量重症成年患者调整护理方式。
向14家以英语为主要临床语言的加拿大儿科重症监护病房的医疗主任发送了一份包含40个问题的调查问卷。该调查旨在了解儿科重症监护病房在新冠疫情期间进行的各种调整。
在回复调查问卷的13家儿科重症监护病房中（回复率：13/14，93%），有10家（77%）至少参与了一项调整措施，以支持新冠成年患者的涌入。主要挑战包括组织混乱、自主权丧失和患者护理受到影响。这些调整的显著优势包括学习感和同志情谊。
我们的研究凸显了重症监护应对能力的不足。在新冠疫情期间，加拿大迅速出现了涉及儿科重症监护病房参与成人护理的调整措施。未来，应根据从新冠疫情中学到的经验，制定预先规划的调整措施，以优化强大的重症监护服务。
