Importance of critical care staffing and standard intensive care therapy in the COVID-19 era: a descriptive study of the first epidemic wave at a Swiss tertiary intensive care unit.
Swiss Med Wkly
; 151: w20529, 2021 06 21.
Article
en En
| MEDLINE
| ID: mdl-34233009
ABSTRACT
AIM:
Mortality rates of COVID-19 patients hospitalised in intensive care units (ICUs) are generally high. Availability of ICU resources might influence clinical outcomes. The aim of this study was to examine the clinical course of the 42 patients treated during the first epidemic wave between 2 March and 20 May 2020 at the tertiary ICU of the Bern University Hospital, where staffing, equipment and drugs were not limited.METHODS:
For this descriptive study, retrospective data of the first COVID-19 wave in an interdisciplinary adult ICU of a Swiss University hospital was used. The study included data regarding healthcare staffing and COVID-19 patients. The primary outcome was the ICU mortality in COVID-19 patients.RESULTS:
Patients’ median age was 61 years (range 32–86), simplified acute physiology score (SAPS-II) was 46 (13–90), 81% of the patients were males, 79% were mechanically ventilated (3 of them on extracorporeal membrane oxygenation), 31% were under renal replacement therapy and 21% received steroids. All patients were fully anticoagulated from the time of admission. No off-label experimental antiviral or anti-inflammatory drugs were used with the exception of one patient, and antibiotic prescription was restrictive. Nurse-to-patient ratio was 11 during all shifts, and the physician-to-patient ratio was 14 (day shift) and 110 (night shift). Infectious disease specialists and physiotherapists were present every day. The median ICU length of stay was 10 days (1–38) days, and ICU and hospital mortality rates were 7% and 12%, respectively.CONCLUSION:
Careful intensive care treatment, without off-label drug use but including steroids in selected cases, combined with an interdisciplinary approach and provision of sufficient human resources, were associated with low ICU and hospital mortality rates despite high disease severity. Availability of qualified human resources may have an important impact on the outcome of COVID-19.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cuidados Críticos
/
Recursos Humanos
/
COVID-19
/
Unidades de Cuidados Intensivos
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Aged80
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Swiss Med Wkly
Asunto de la revista:
MEDICINA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Suiza