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. 77years], 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. 42mmHg; 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 14days of the Covid-19 outbreak, avoiding resource rationing.
Use of critical care resources during the first 2 weeks (February 24-March 8, 2020) of the Covid-19 outbreak in Italy / Tonetti, Tommaso; Grasselli, Giacomo; Zanella, Alberto; Pizzilli, Giacinto; Fumagalli, Roberto; Piva, Simone; Lorini, Luca; Iotti, Giorgio; Foti, Giuseppe; Colombo, Sergio; Vivona, Luigi; Rossi, Sandra; Girardis, Massimo; Agnoletti, Vanni; Campagna, Anselmo; Gordini, Giovanni; Navalesi, Paolo; Boscolo, Annalisa; Graziano, Alessandro; Valeri, Ilaria; Vianello, Andrea; Cereda, Danilo; Filippini, Claudia; Cecconi, Maurizio; Locatelli, Franco; Bartoletti, Michele; Giannella, Maddalena; Viale, Pierluigi; Antonelli, Massimo; Nava, Stefano; Pesenti, Antonio; Ranieri, V Marco. - In: ANNALS OF INTENSIVE CARE. - ISSN 2110-5820. - ELETTRONICO. - 10:1(2020), pp. 133.1-133.8. [10.1186/s13613-020-00750-z]
Use of critical care resources during the first 2 weeks (February 24-March 8, 2020) of the Covid-19 outbreak in Italy
Tonetti, Tommaso
;Zanella, Alberto;Agnoletti, Vanni;Bartoletti, Michele;Giannella, Maddalena;Viale, Pierluigi;Nava, Stefano;Ranieri, V Marco
2020
Abstract
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. 77years], 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. 42mmHg; 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 14days of the Covid-19 outbreak, avoiding resource rationing.File | Dimensione | Formato | |
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