TY - JOUR
T1 - Use of critical care resources during the first 2 weeks (February 24-March 8, 2020) of the Covid-19 outbreak in Italy
AU - COVID-19 Northern Italian ICU Network
AU - Tonetti, Tommaso
AU - Grasselli, Giacomo
AU - Zanella, Alberto
AU - Pizzilli, Giacinto
AU - Fumagalli, Roberto
AU - Piva, Simone
AU - Lorini, Luca
AU - Iotti, Giorgio
AU - Foti, Giuseppe
AU - Colombo, Sergio
AU - Vivona, Luigi
AU - Rossi, Sandra
AU - Girardis, Massimo
AU - Agnoletti, Vanni
AU - Campagna, Anselmo
AU - Gordini, Giovanni
AU - Navalesi, Paolo
AU - Boscolo, Annalisa
AU - Graziano, Alessandro
AU - Valeri, Ilaria
AU - Vianello, Andrea
AU - Cereda, Danilo
AU - Filippini, Claudia
AU - Cecconi, Maurizio
AU - Locatelli, Franco
AU - Bartoletti, Michele
AU - Giannella, Maddalena
AU - Viale, Pierluigi
AU - Antonelli, Massimo
AU - Nava, Stefano
AU - Pesenti, Antonio
AU - Ranieri, V Marco
PY - 2020/10/12
Y1 - 2020/10/12
N2 - BACKGROUND: A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary.RESULTS: In order to evaluate the impact of Covid-19 on the ICU capacity to manage critically ill patients, we performed a retrospective analysis of the first 2 weeks of the outbreak (February 24-March 8). Data were collected from regional registries and from a case report form sent to participating sites. ICU beds increased from 1545 to 1989 (28.7%), and patients receiving respiratory support outside the ICU increased from 4 (0.6%) to 260 (37.0%). Patients receiving respiratory support outside the ICU were significantly older [65 vs. 77 years], had more cerebrovascular (5.8 vs. 13.1%) and renal (5.3 vs. 10.0%) comorbidities and less obesity (31.4 vs. 15.5%) than patients admitted to the ICU. PaO2/FiO2 ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO2 and base excess were lower [34 vs. 42 mmHg; 0.60 vs. 1.30] in patients receiving respiratory support outside the ICU than in patients admitted to the ICU, respectively.CONCLUSIONS: Increase in ICU beds and use of out-of-ICU respiratory support allowed effective management of the first 14 days of the Covid-19 outbreak, avoiding resource rationing.
AB - BACKGROUND: A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary.RESULTS: In order to evaluate the impact of Covid-19 on the ICU capacity to manage critically ill patients, we performed a retrospective analysis of the first 2 weeks of the outbreak (February 24-March 8). Data were collected from regional registries and from a case report form sent to participating sites. ICU beds increased from 1545 to 1989 (28.7%), and patients receiving respiratory support outside the ICU increased from 4 (0.6%) to 260 (37.0%). Patients receiving respiratory support outside the ICU were significantly older [65 vs. 77 years], had more cerebrovascular (5.8 vs. 13.1%) and renal (5.3 vs. 10.0%) comorbidities and less obesity (31.4 vs. 15.5%) than patients admitted to the ICU. PaO2/FiO2 ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO2 and base excess were lower [34 vs. 42 mmHg; 0.60 vs. 1.30] in patients receiving respiratory support outside the ICU than in patients admitted to the ICU, respectively.CONCLUSIONS: Increase in ICU beds and use of out-of-ICU respiratory support allowed effective management of the first 14 days of the Covid-19 outbreak, avoiding resource rationing.
U2 - 10.1186/s13613-020-00750-z
DO - 10.1186/s13613-020-00750-z
M3 - Article
C2 - 33044646
VL - 10
SP - 133
JO - Annals of Intensive Care
JF - Annals of Intensive Care
SN - 2110-5820
IS - 1
ER -