Characteristics and Outcomes of COVID-19 Patients with Respiratory Failure Admitted to a "Pandemic Ready" Intensive Care Unit - Lessons from Singapore
Annals of the Academy of Medicine, Singapore
;
: 434-448, 2020.
Article
in English
| WPRIM
| ID: wpr-827330
ABSTRACT
INTRODUCTION@#Singapore was one of the first countries affected by the coronavirus disease 2019 (COVID-19) pandemic but has been able to prevent its healthcare system and intensive care units (ICU) from being overwhelmed. We describe the clinical features, management and outcomes of COVID-19 patients with respiratory failure admitted to our ICU.@*MATERIALS AND METHODS@#A case series of COVID-19 patients admitted to our ICU for respiratory failure from 7 February, with data censoring at 30 June 2020, was performed from a review of medical records.@*RESULTS@#Twenty-two COVID-19 patients were admitted to our ICU for respiratory failure. The median age was 54.5 years (IQR 30-45.5), 72.7% were male and had at least one comorbidity. The Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were 2.5 (IQR 1.25-7) and 10 (8.25-12) respectively. Thirteen patients required invasive mechanical ventilation (IMV) and had a median PaO2/FiO2 ratio of 194 mmHg (IQR 173-213) after intubation. The 28-day survival was 100%, with 2 patients demising subsequently. The overall ICU mortality rate was 9.1% at the time of data censoring. In IMV survivors, length of IMV and ICU stay were 11 days (IQR 9-17.75) and 16 days (IQR 12-32) respectively.@*CONCLUSION@#Low COVID-19 ICU mortality was observed in our "pandemic-ready" ICU. This was achieved by having adequate surge capacity to facilitate early ICU admission and IMV, lung protective ventilation, and slow weaning. Being able to maintain clinical standards and evidence-based practices without having to resort to rationing contributed to better outcomes.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pneumonia, Viral
/
Respiration, Artificial
/
Respiratory Insufficiency
/
Singapore
/
Therapeutics
/
Virology
/
Retrospective Studies
/
Mortality
/
Hospital Mortality
/
Coronavirus Infections
Type of study:
Practice guideline
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Observational study
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Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
Annals of the Academy of Medicine, Singapore
Year:
2020
Type:
Article
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