Koraishy Farrukh M, Mallipattu Sandeep K
Division of Nephrology, Department of Medicine, Stony Brook University Hospital, , Stony Brook, NY, United States.
Front Nephrol. 2023 Oct 26;3:1266967. doi: 10.3389/fneph.2023.1266967. eCollection 2023.
The COVID-19 pandemic resulted in an unprecedented burden on intensive care units (ICUs). With increased demands and limited supply, critical care resources, including dialysis machines, became scarce, leading to the undertaking of value-based cost-effectiveness analyses and the rationing of resources to deliver patient care of the highest quality. A high proportion of COVID-19 patients admitted to the ICU required dialysis, resulting in a major burden on resources such as dialysis machines, nursing staff, technicians, and consumables such as dialysis filters and solutions and anticoagulation medications. Artificial intelligence (AI)-based big data analytics are now being utilized in multiple data-driven healthcare services, including the optimization of healthcare system utilization. Numerous factors can impact dialysis resource allocation to critically ill patients, especially during public health emergencies, but currently, resource allocation is determined using a small number of traditional factors. Smart analytics that take into account all the relevant healthcare information in the hospital system and patient outcomes can lead to improved resource allocation, cost-effectiveness, and quality of care. In this review, we discuss dialysis resource utilization in critical care, the impact of the COVID-19 pandemic, and how AI can improve resource utilization in future public health emergencies. Research in this area should be an important priority.
新冠疫情给重症监护病房(ICU)带来了前所未有的负担。随着需求增加而供应有限,包括透析机在内的重症护理资源变得稀缺,这导致了基于价值的成本效益分析以及为提供最高质量的患者护理而进行的资源配给。入住ICU的新冠患者中有很大一部分需要透析,这给透析机、护理人员、技术人员以及透析滤器、溶液和抗凝药物等耗材等资源带来了巨大负担。基于人工智能(AI)的大数据分析目前正被用于多种数据驱动的医疗服务中,包括优化医疗系统的利用。许多因素会影响对重症患者的透析资源分配,尤其是在突发公共卫生事件期间,但目前,资源分配是根据少数传统因素来确定的。考虑到医院系统中的所有相关医疗信息和患者预后的智能分析可以改善资源分配、成本效益和护理质量。在本综述中,我们讨论了重症护理中的透析资源利用、新冠疫情的影响,以及人工智能如何在未来突发公共卫生事件中提高资源利用。该领域的研究应成为重要的优先事项。