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2.
Cent Eur J Public Health ; 29(1): 3-8, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33831279

RESUMEN

OBJECTIVES: The aim of the study was to obtain data on demands on the intensive care capacities to treat COVID-19 patients, and to identify predictors for in-hospital mortality. METHODS: The prospective observational multicentre study carried out from 1 March till 30 June 2020 included adult patients with confirmed SARS-CoV-2 infection with respiratory failure requiring ventilatory support or high-flow nasal oxygen therapy (HFNO). RESULTS: Seventy-four patients, 46 males and 28 females, median age 67.5 (Q1-Q3: 56-75) years, were included. Sixty-four patients (86.5%) had comorbidity. Sixty-six patients (89.2%) were mechanically ventilated, four of them received extracorporeal membrane oxygenation therapy. Eight patients (10.8%) were treated with non-invasive ventilation and HFNO only. The median of intensive care unit (ICU) stay was 22.5 days. Eighteen patients (24.3%) needed continuous renal replacement therapy. Thirty patients (40.5%) died. Age and acute kidney injury were identified as independent predictors of in-hospital death, and chronic kidney disease showed trend towards statistical significance for poor outcome. CONCLUSIONS: Sufficient number of intensive care beds, organ support equipment and well-trained staff is a decisive factor in managing the COVID-19 epidemic. The study focused on the needs of intensive care in the COVID-19 patients. Advanced age and acute kidney injury were identified as independent predictors for in-hospital mortality. When compared to clinical course and ICU management of patients with severe community-acquired pneumonia caused by other pathogens, we observed prolonged need for ventilatory support, high rate of progression to acute respiratory distress syndrome and significant mortality in studied population.


Asunto(s)
Adulto , Anciano , Cuidados Críticos , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Estudios Prospectivos
3.
Health Res Policy Syst ; 19(1): 47, 2021 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-33789671

RESUMEN

BACKGROUND: At the height of the COVID-19 pandemic, Thailand had almost depleted its critical care resources, particularly intensive care unit (ICU) beds and ventilators. This prompted the necessity to develop a national guideline for resource allocation. This paper describes the development process of a national guideline for critical resource allocation in Thailand during the COVID-19 pandemic. METHODS: The guideline development process consisted of three steps: (1) rapid review of existing rationing guidelines and literature; (2) interviews of Thai clinicians experienced in caring for COVID-19 cases; and (3) multi-stakeholder consultations. At steps 1 and 2, data was synthesized and categorized using a thematic and content analysis approach, and this guided the formulation of the draft guideline. Within step 3, the draft Thai critical care allocation guideline was debated and finalized before entering the policy-decision stage. RESULTS: Three-order prioritization criteria consisting of (1) clinical prognosis using four tools (Charlson Comorbidity Index, Sequential Organ Failure Assessment, frailty assessment and cognitive impairment assessment), (2) number of life-years saved and (3) social usefulness were proposed by the research team based on literature reviews and interviews. At consultations, stakeholders rejected using life-years as a criterion due to potential age and gender discrimination, as well as social utility due to a concern it would foster public distrust, as this judgement can be arbitrary. It was agreed that the attending physician is required to be the decision-maker in the Thai medico-legal context, while a patient review committee would play an advisory role. Allocation decisions are to be documented for transparency, and no appealing mechanism is to be applied. This guideline will be triggered only when demand exceeds supply after the utmost efforts to mobilize surge capacity. Once implemented, it is applicable to all patients, COVID-19 and non-COVID-19, requiring critical care resources prior to ICU admission and during ICU stay. CONCLUSIONS: The guideline development process for the allocation of critical care resources in the context of the COVID-19 outbreak in Thailand was informed by scientific evidence, medico-legal context, existing norms and societal values to reduce risk of public distrust given the sensitive nature of the issue and ethical dilemmas of the guiding principle, though it was conducted at record speed. Our lessons can provide an insight for the development of similar prioritization guidelines, especially in other low- and middle-income countries.


Asunto(s)
Cuidados Críticos , Enfermedad Crítica , Asignación de Recursos para la Atención de Salud , Accesibilidad a los Servicios de Salud , Pandemias , Guías de Práctica Clínica como Asunto , Toma de Decisiones , Revelación , Ética Médica , Recursos en Salud , Hospitalización , Humanos , Unidades de Cuidados Intensivos , Pronóstico , Discriminación Social , Valores Sociales , Participación de los Interesados , Tailandia , Confianza
4.
Artículo en Inglés | MEDLINE | ID: mdl-33800903

RESUMEN

The COVID-19 pandemic had a significant effect on healthcare globally. Additional pressure created by coronavirus adversely affected the mental health and psychological well-being of healthcare workers, leading many to question their desire and willingness to continue working in healthcare. This study aimed to identify predictors for career change ideation among healthcare professionals in two countries; Lithuania and the United Kingdom amid the coronavirus pandemic. In total, 610 healthcare professionals from Lithuania and the UK (285 and 325, respectively) participated in a survey from May to August 2020. Psychological distress and psychological well-being were measured using the self-report scales "DASS-21" and "WHO-5". Almost half of the sample (49.2%), 59.6% and 40.0% in Lithuanian and the UK, respectively, exhibited career change ideation, the country effect was significant (AOR = 2.21, p < 0.001). Stronger ideation to leave healthcare was predicted by higher levels of depression (AOR = 1.10, p = 0.005), stress (AOR = 1.10, p = 0.007), anxiety surrounding inadequate personal protective equipment (AOR = 2.27, p = 0.009), and lower psychological well-being scores (AOR = 1.10, p = 0.007). We conclude that psychosocial support must be provided for healthcare professionals to prevent burnout and loss of staff amid the pandemic.


Asunto(s)
Distrés Psicológico , Ansiedad/epidemiología , Cuidados Críticos , Personal de Salud , Humanos , Lituania/epidemiología , Pandemias , Reino Unido/epidemiología
6.
Orv Hetil ; 162(17): 652-667, 2021 04 10.
Artículo en Húngaro | MEDLINE | ID: mdl-33838024

RESUMEN

Összefoglaló. A SARS-CoV-2-fertozés ritka gyermekkori szövodménye a sokszervi gyulladás, angol terminológiával paediatric inflammatory multisystem syndrome (PIMS). Két vagy több szerv érintettségével járó, súlyos tünetekkel induló betegségrol van szó, amelynek tünetei átfedést mutatnak a Kawasaki-betegséggel, a toxikus sokk szindrómával és a makrofágaktivációs szindrómával. A PIMS-betegek intenzív terápiás osztályon vagy intenzív terápiás háttérrel rendelkezo intézményben kezelendok, ahol biztosítottak a kardiológiai ellátás feltételei is. A szükséges immunterápia a klinikai prezentációtól függ. A jelen közleményben a szerzok a releváns nemzetközi irodalom áttekintését követoen ajánlást tesznek a PIMS diagnosztikai és terápiás algoritmusára. Orv Hetil. 2021; 162(17): 652-667. Summary. Pediatric inflammatory multisystem syndrome (PIMS) is a rare complication of SARS-CoV-2 infection in children. PIMS is a severe condition, involving two or more organ systems. The symptoms overlap with Kawasaki disease, toxic shock syndrome and macrophage activation syndrome. PIMS patients should be treated in an intensive care unit or in an institution with an intensive care background, where cardiological care is also provided. The required specific immunotherapy depends on the clinical presentation. In this paper, after reviewing the relevant international literature, the authors make a recommendation for the diagnostic and therapeutic algorithm for PIMS. Orv Hetil. 2021; 162(17): 652-667.


Asunto(s)
Síndrome de Respuesta Inflamatoria Sistémica , Algoritmos , /diagnóstico , /virología , Niño , Cuidados Críticos , Humanos , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/terapia , Síndrome de Respuesta Inflamatoria Sistémica/virología
7.
Med Klin Intensivmed Notfmed ; 116(3): 190-197, 2021 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-33682018

RESUMEN

BACKGROUND: Demographic change, medical progress, pandemics, and mass casualty events may cause an increased demand for intensive and emergency medical care resources. There is thus a definite need for fair allocation criteria. OBJECTIVE: The rationale, structure, and criteria for allocation of intensive and emergency medical care resources are presented and discussed. MATERIALS AND METHODS: Analysis and discussion of German literature about the topic. RESULTS AND CONCLUSIONS: Decisions on the allocation of intensive and emergency medical care resources are made on different levels (micro-, meso-, and macrolevel). They shall fulfill minimum demands in terms of procedure and content. Consequent and careful examination of indication and evidence of therapeutic decisions as well as consequent and careful examination of the patient's definite or presumed consent helps to take responsibility for fair allocation decisions.


Asunto(s)
Servicios Médicos de Urgencia , Triaje , Cuidados Críticos , Asignación de Recursos para la Atención de Salud , Humanos , Pandemias , Asignación de Recursos
8.
Med Klin Intensivmed Notfmed ; 116(3): 198-204, 2021 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-33687485

RESUMEN

BACKGROUND: Lack of knowledge about patient preferences is a contributing factor for inappropriate therapy. Advance care planning (ACP) is a novel concept for meaningful advance directives, but it is still not widely known in Germany. OBJECTIVE: An overview of the concept of ACP, development and its implementation with respect to intensive care is provided. METHODS: A narrative literature review was performed. RESULTS: ACP is a broad concept which requires facilitated discussions with trained medical staff. The process can lead to different ACP documents. It is also possible to facilitate discussions with patient proxies. Furthermore, ACP has potential because of the proven validity of advance directives and the prompt applicability of directives in an emergency. Prerequisites for ACP include the provision of resources, notably for the training of appropriate facilitators, and the implementation or extension of counseling structures. CONCLUSIONS: Advanced care planning (ACP) is a promising concept. However, some requirements must be met to implement ACP into daily practice.


Asunto(s)
Planificación Anticipada de Atención , Directivas Anticipadas , Cuidados Críticos , Alemania , Humanos
9.
Med Klin Intensivmed Notfmed ; 116(3): 210-215, 2021 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-33687486

RESUMEN

After a stay on an intensive care unit (ICU), patients and relatives may be affected by psychological consequences such as anxiety, depression or posttraumatic stress disorder. ICU diaries written for patients during the stay by clinicians and relatives can alleviate the consequences. Diaries can contribute to the humanization of intensive care through the person-centered approach. A case report illustrates the perspective and benefits from a patient's perspective.


Asunto(s)
Enfermedad Crítica , Trastornos por Estrés Postraumático , Cuidados Críticos , Familia , Humanos , Unidades de Cuidados Intensivos , Trastornos por Estrés Postraumático/terapia
10.
Med Klin Intensivmed Notfmed ; 116(3): 267-276, 2021 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-33740067

RESUMEN

Palliative care is aimed at patients with incurable oncological and non-oncological diseases and their relatives with the aim of maintaining or improving their quality of life. In order to integrate palliative care into acute care medicine, palliative care training and continuing education for medical and nursing staff is recommended. Appropriate screening tools and standard operating procedures should be implemented to identify and address palliative care needs in emergency situations. For palliative care, established specialist palliative care services can be called upon for advice and/or cotreatment. Symptom control, treatment of malignant wounds, difficult ethical decision-making, and communication difficulties with patients, their legal representatives or relatives are the tasks of palliative care experts.


Asunto(s)
Medicina , Cuidados Paliativos , Comunicación , Cuidados Críticos , Humanos , Calidad de Vida
12.
Medicine (Baltimore) ; 100(9): e24604, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655925

RESUMEN

ABSTRACT: Mortality of critically ill patients with coronavirus disease 2019 (COVID-19) was high. Aims to examine whether time from symptoms onset to intensive care unit (ICU) admission affects incidence of extra-pulmonary complications and prognosis in order to provide a new insight for reducing the mortality. A single-centered, retrospective, observational study investigated 45 critically ill patients with COVID-19 hospitalized in ICU of The Third People's Hospital of Yichang from January 17 to March 29, 2020. Patients were divided into 2 groups according to time from symptoms onset to ICU admission (>7 and ≤7 days) and into 2 groups according to prognosis (survivors and non-survivors). Epidemiological, clinical, laboratory, radiological characteristics and treatment data were studied. Compared with patients who admitted to the ICU since symptoms onset ≤7 days (55.6%), patients who admitted to the ICU since symptoms onset >7 days (44.4%) were more likely to have extra-pulmonary complications (19 [95.0%] vs 16 [64.0%], P = .034), including acute kidney injury, cardiac injury, acute heart failure, liver dysfunction, gastrointestinal hemorrhage, hyperamylasemia, and hypernatremia. The incidence rates of acute respiratory distress syndrome, pneumothorax, and hospital-acquired pneumonia had no difference between the 2 groups. Except activated partial thromboplastin and Na+ concentration, the laboratory findings were worse in group of time from symptoms onset to ICU admission >7 days. There was no difference in mortality between the 2 groups. Of the 45 cases in the ICU, 19 (42.2%) were non-survivors, and 16 (35.6%) were with hospital-acquired pneumonia. Among these non-survivors, hospital-acquired pneumonia was up to 12 (63.2%) besides higher incidence of extra-pulmonary complications. However, hospital-acquired pneumonia occurred in only 4 (15.4%) survivors. Critically ill patients with COVID-19 who admitted to ICU at once might get benefit from intensive care via lower rate of extra-pulmonary complications.


Asunto(s)
Cuidados Críticos , Enfermedad Crítica , Evaluación de Síntomas , Tiempo de Tratamiento/estadística & datos numéricos , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/etiología , /diagnóstico , /fisiopatología , China/epidemiología , Cuidados Críticos/métodos , Cuidados Críticos/estadística & datos numéricos , Enfermedad Crítica/mortalidad , Enfermedad Crítica/terapia , Enfermedades del Sistema Digestivo/diagnóstico , Enfermedades del Sistema Digestivo/etiología , Femenino , Neumonía Asociada a la Atención Médica/diagnóstico , Neumonía Asociada a la Atención Médica/mortalidad , Cardiopatías/diagnóstico , Humanos , Hiperamilasemia/diagnóstico , Hiperamilasemia/etiología , Hipernatremia/diagnóstico , Hipernatremia/etiología , Masculino , Persona de Mediana Edad , Evaluación de Procesos y Resultados en Atención de Salud , Pronóstico , Análisis de Supervivencia , Evaluación de Síntomas/métodos , Evaluación de Síntomas/estadística & datos numéricos
13.
Sci Rep ; 11(1): 5018, 2021 03 03.
Artículo en Inglés | MEDLINE | ID: mdl-33658593

RESUMEN

One major bottleneck in the ongoing COVID-19 pandemic is the limited number of critical care beds. Due to the dynamic development of infections and the time lag between when patients are infected and when a proportion of them enters an intensive care unit (ICU), the need for future intensive care can easily be underestimated. To infer future ICU load from reported infections, we suggest a simple statistical model that (1) accounts for time lags and (2) allows for making predictions depending on different future growth of infections. We have evaluated our model for three heavily affected regions in Europe, namely Berlin (Germany), Lombardy (Italy), and Madrid (Spain). Before extensive containment measures made an impact, we first estimate the region-specific model parameters, namely ICU rate, time lag between infection, and ICU admission as well as length of stay in ICU. Whereas for Berlin, an ICU rate of 6%, a time lag of 6 days, and a stay of 12 days in ICU provide the best fit of the data, for Lombardy and Madrid the ICU rate was higher (18% and 15%) and the time lag (0 and 3 days) and the stay in ICU (3 and 8 days) shorter. The region-specific models are then used to predict future ICU load assuming either a continued exponential phase with varying growth rates (0-15%) or linear growth. By keeping the growth rates flexible, this model allows for taking into account the potential effect of diverse containment measures. Thus, the model can help to predict a potential exceedance of ICU capacity depending on future growth. A sensitivity analysis for an extended time period shows that the proposed model is particularly useful for exponential phases of the disease.


Asunto(s)
/epidemiología , Predicción/métodos , Unidades de Cuidados Intensivos/tendencias , Cuidados Críticos/estadística & datos numéricos , Cuidados Críticos/tendencias , Europa (Continente)/epidemiología , Alemania/epidemiología , Hospitalización/estadística & datos numéricos , Hospitalización/tendencias , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Italia/epidemiología , Modelos Estadísticos , Pandemias , España/epidemiología
14.
EBioMedicine ; 65: 103246, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33647767

RESUMEN

BACKGROUND: While SARS-CoV-2 similarly infects men and women, COVID-19 outcome is less favorable in men. Variability in COVID-19 severity may be explained by differences in the host genome. METHODS: We compared poly-amino acids variability from WES data in severely affected COVID-19 patients versus SARS-CoV-2 PCR-positive oligo-asymptomatic subjects. FINDINGS: Shorter polyQ alleles (≤22) in the androgen receptor (AR) conferred protection against severe outcome in COVID-19 in the first tested cohort (both males and females) of 638 Italian subjects. The association between long polyQ alleles (≥23) and severe clinical outcome (p = 0.024) was also validated in an independent cohort of Spanish men <60 years of age (p = 0.014). Testosterone was higher in subjects with AR long-polyQ, possibly indicating receptor resistance (p = 0.042 Mann-Whitney U test). Inappropriately low serum testosterone level among carriers of the long-polyQ alleles (p = 0.0004 Mann-Whitney U test) predicted the need for intensive care in COVID-19 infected men. In agreement with the known anti-inflammatory action of testosterone, patients with long-polyQ and age ≥60 years had increased levels of CRP (p = 0.018, not accounting for multiple testing). INTERPRETATION: We identify the first genetic polymorphism that appears to predispose some men to develop more severe disease. Failure of the endocrine feedback to overcome AR signaling defects by increasing testosterone levels during the infection leads to the polyQ tract becoming dominant to serum testosterone levels for the clinical outcome. These results may contribute to designing reliable clinical and public health measures and provide a rationale to test testosterone as adjuvant therapy in men with COVID-19 expressing long AR polyQ repeats. FUNDING: MIUR project "Dipartimenti di Eccellenza 2018-2020" to Department of Medical Biotechnologies University of Siena, Italy (Italian D.L. n.18 March 17, 2020) and "Bando Ricerca COVID-19 Toscana" project to Azienda Ospedaliero-Universitaria Senese. Private donors for COVID-19 research and charity funds from Intesa San Paolo.


Asunto(s)
/patología , Péptidos/genética , Receptores Androgénicos/genética , Anciano , Estudios de Casos y Controles , Cuidados Críticos/estadística & datos numéricos , Femenino , Genoma Humano/genética , Humanos , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple/genética , Factores de Riesgo , Índice de Severidad de la Enfermedad , España , Testosterona/sangre
16.
Neurophysiol Clin ; 51(2): 183-191, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33685769

RESUMEN

OBJECTIVE: To assess whether patients with acute inflammatory demyelinating polyneuropathy (AIDP) associated with SARS-CoV-2 show characteristic electrophysiological features. METHODS: Clinical and electrophysiological findings of 24 patients with SARS-CoV-2 infection and AIDP (S-AIDP) and of 48 control AIDP (C-AIDP) without SARS-CoV-2 infection were compared. RESULTS: S-AIDP patients more frequently developed respiratory failure (83.3% vs. 25%, P=0.000) and required intensive care unit (ICU) hospitalization (58.3% vs. 31.3%, P=0.000). In C-AIDP, distal motor latencies (DMLs) were more frequently prolonged (70.9% vs. 26.2%, P=0.000) whereas in S-AIDP distal compound muscle action potential (dCMAP) durations were more frequently increased (49.5% vs. 32.4%, P=0.002) and F waves were more often absent (45.6% vs. 31.8%, P=0.011). Presence of nerves with increased dCMAP duration and normal or slightly prolonged DML was elevenfold higher in S-AIDP (31.1% vs. 2.8%, P=0.000);11 S-AIDP patients showed this pattern in 2 nerves. CONCLUSION: Increased dCMAP duration, thought to be a marker of acquired demyelination, can also be oserved in critical illness myopathy. In S-AIDP patients, an increased dCMAP duration dissociated from prolonged DML, suggests additional muscle fiber conduction slowing, possibly due to a COVID-19-related hyperinflammatory state. Absent F waves, at least in some S-AIDP patients, may reflect α-motor neuron hypoexcitability because of immobilization during the ICU stay. These features should be considered in the electrodiagnosis of SARS-CoV-2 patients with weakness, to avoid misdiagnosis.


Asunto(s)
/complicaciones , Síndrome de Guillain-Barré/etiología , Síndrome de Guillain-Barré/fisiopatología , Potenciales de Acción , Adulto , Anciano , Anciano de 80 o más Años , Cuidados Críticos/estadística & datos numéricos , Electrodiagnóstico , Fenómenos Electrofisiológicos , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Neuronas Motoras , Músculo Esquelético/fisiopatología , Conducción Nerviosa , Insuficiencia Respiratoria/etiología , Células Receptoras Sensoriales
18.
BMC Pharmacol Toxicol ; 22(1): 14, 2021 03 11.
Artículo en Inglés | MEDLINE | ID: mdl-33706794

RESUMEN

BACKGROUND: The impact of prior exposure to systemic corticosteroids on COVID-19 severity in patients hospitalized for a SARS-CoV-2 pneumonia is not known. The present study was designed to answer to this question. METHODS: The population study was the Covid-Clinic-Toul cohort which records data about all hospitalized patients with a positive reverse transcriptase polymerase chain reaction for a SARS-CoV-2 infection at Toulouse University hospital, France. Exposure to systemic corticosteroids was assessed at hospital admission. A propensity score (PS) according to corticosteroid exposure was calculated including comorbidities, clinical, radiological and biological variables that impact COVID-19 severity. The primary outcome was composite, including admission to intensive care unit, need of mechanical ventilation and death occurring during the 14 days after hospital admission. Logistic regression models adjusted for the PS (overlap weighting) provided odds ratios (ORs) and their 95% confidence intervals (95% CIs). RESULTS: Overall, 253 patients were included in the study. Median age was 64 years, 140 patients (59.6%) were men and 218 (86.2%) had at least one comorbidity. Seventeen patients (6.7%) were exposed to corticosteroids before hospital admission. Chronic inflammatory disease (n = 8) was the most frequent indication. One hundred and twenty patients (47.4%) met the composite outcome. In the crude model, the OR of previous exposure to systemic corticosteroids was 1.64; 95% CI: 0.60-4.44. In the adjusted model, it was 1.09 (95% CI: 0.65-1.83). CONCLUSION: Overall, this study provide some evidences for an absence of an increased risk of unfavorable outcome with previous exposure to corticosteroids in the general setting of patients hospitalized for COVID-19.


Asunto(s)
Corticoesteroides/uso terapéutico , /tratamiento farmacológico , Anciano , Estudios de Cohortes , Comorbilidad , Cuidados Críticos/estadística & datos numéricos , Femenino , Hospitalización , Humanos , Inflamación/tratamiento farmacológico , Inflamación/etiología , Masculino , Persona de Mediana Edad , Puntaje de Propensión , Respiración Artificial/estadística & datos numéricos , Resultado del Tratamiento
19.
Artículo en Alemán | MEDLINE | ID: mdl-33725738

RESUMEN

Patients who undergo high-risk surgical procedures represent a large proportion of admissions to intensive care units. Postoperative outcomes are a result of the complex interplay between the exact surgical procedure performed, the previous health of the patient, and specific intra- and postoperative events. Appropriate triage of patients to intensive care postoperatively may have a relevant impact on patient outcomes after high-risk surgery. It remains challenging to accurately identify patients who are at high risk of complications or death and target the patients who will benefit most from this highest level of postoperative care. "Failure to rescue" as an expression for the proportion of deaths in patients who developed a postoperative complication out of the total number of patients who developed a postoperative complication adds to the mortality of surgical patients. General wards may not properly recognize and manage postoperative complications when they occur which emphasises the necessity for adequate triage of intensive care capacity. When admission to the intensive care unit is granted patient transport from the operating room to the intensive care unit and patient handover to ICU-staff are further issues relevant to postoperative patient safety. Intrahospital transports are prone to adverse events and need careful preparation to be executed safely. In addition, exchange of clinical information during the transfer of responsibility between anesthesiologist and the intensive care physician has been recognized as a high-risk area for medical errors to occur. Structured handover protocols can reduce communication breakdowns during postoperative transfer of patients from the OR to the ICU.


Asunto(s)
Cuidados Críticos , Unidades de Cuidados Intensivos , Hospitalización , Humanos , Quirófanos , Cuidados Posoperatorios
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