Cargando…

Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy

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 impa...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7549086/
https://www.ncbi.nlm.nih.gov/pubmed/33044646
http://dx.doi.org/10.1186/s13613-020-00750-z
_version_ 1783592736938524672
author 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
author_facet 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
author_sort Tonetti, Tommaso
collection PubMed
description 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. PaO(2)/FiO(2) ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO(2) 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.
format Online
Article
Text
id pubmed-7549086
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Springer International Publishing
record_format MEDLINE/PubMed
spelling pubmed-75490862020-10-14 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 Ann Intensive Care Research 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. PaO(2)/FiO(2) ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO(2) 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. Springer International Publishing 2020-10-12 /pmc/articles/PMC7549086/ /pubmed/33044646 http://dx.doi.org/10.1186/s13613-020-00750-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Research
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
Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy
title Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy
title_full Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy
title_fullStr Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy
title_full_unstemmed Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy
title_short Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy
title_sort use of critical care resources during the first 2 weeks (february 24–march 8, 2020) of the covid-19 outbreak in italy
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7549086/
https://www.ncbi.nlm.nih.gov/pubmed/33044646
http://dx.doi.org/10.1186/s13613-020-00750-z
work_keys_str_mv AT tonettitommaso useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT grasselligiacomo useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT zanellaalberto useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT pizzilligiacinto useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT fumagalliroberto useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT pivasimone useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT loriniluca useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT iottigiorgio useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT fotigiuseppe useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT colombosergio useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT vivonaluigi useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT rossisandra useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT girardismassimo useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT agnolettivanni useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT campagnaanselmo useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT gordinigiovanni useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT navalesipaolo useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT boscoloannalisa useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT grazianoalessandro useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT valeriilaria useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT vianelloandrea useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT ceredadanilo useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT filippiniclaudia useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT cecconimaurizio useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT locatellifranco useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT bartolettimichele useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT giannellamaddalena useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT vialepierluigi useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT antonellimassimo useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT navastefano useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT pesentiantonio useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT ranierivmarco useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly
AT useofcriticalcareresourcesduringthefirst2weeksfebruary24march82020ofthecovid19outbreakinitaly