ABSTRACT
Background: Timing of kidney replacement therapy (KRT) and transplant referral in chronic kidney disease (CKD) G4 and G5 is a difficult topic. The COVID-19 pandemic has disrupted nearly all aspects of healthcare, including the process of KRT plan. This study examined if the addition of a Transition Coordinator (TC) improved KRT transition plan despite the pandemic. Methods: Retrospective descriptive study examining patients at single academic practice with eGFR <20 that completed CKD educational program (CKDEP). Control Group: 5/1/19-1/31/20 with in-person CKDEP, no TC. Intervention Group (IG): 5/1/20-1/31/21 with virtual or in-person CKDEP with addition of TC. TC called patient monthly to assess barriers to KRT planning, assist with scheduling, and communicate with Nephrologist. Success was defined as having a KRT plan. Failure was defined as either urgent start dialysis via dialysis catheter (DC) or patients without KRT plan. Results: CG had n=15 while IG had n=47. Both groups were evenly distributed with age, average eGFR (15). The CG had slightly higher rates of urgent starts and patients without KRT plan compared to IG (Table 1). Patients were referred for Vascular access +/-Transplant 20% (3) in CG and 23% in IG. PD +/-Transplant was chosen in 6.7% (1) of CG and 36% (17) of IG. Success and Failure rates were similar in both groups (Table 2). Conclusions: Despite the pandemic, there was no overall change in rate of failure (urgent start or lack of KRT plan), however, individual decreases in these groups were noted. This could indicate that TC may improve outcomes when the pandemic is controlled. Increased interest in PD was noted which could indicate greater understanding via follow up provided by TC. (Table Presented) .
ABSTRACT
Background: The rapidly spreading COVID-19 pandemic was associated with significant nosocomial transmissions and poses a risk to healthcare workers and hospitalized patients. We assessed intensive care units (ICU) resources, COVID-19 preparedness and the availability of personal protective equipment (PPE) to ICU practitioners in Lebanon.
ABSTRACT
Background: The rapidly spreading COVID-19 pandemic was associated with significant nosocomial transmissions and poses a risk to healthcare workers and hospitalized patients. We assessed intensive care units (ICU) resources, COVID-19 preparedness and the availability of personal protective equipment (PPE) to ICU practitioners in Lebanon. Methods: Between March 23 and 31, 2020, 250 ICU physicians working in Lebanon were surveyed on COVID-19 preparedness at their local hospitals, the availability of ICU resources, and adequate PPE. The survey was developed and administered by the Lebanese Society of Critical Care Medicine in collaboration with the Lebanese Pulmonary Society and the Lebanese Society of Anesthesiologists. Results: Eighty-nine ICU physicians working at 51 hospitals in all Lebanese regions completed the survey. The recommended PPE for ICU physicians (N95 masks, face shields and impermeable body-gowns) and the needed fitting and doning/doffing training were available to 34% of respondents. Dedicated wards and ICU for COVID-19 patients, negative pressure ICU rooms, video-laryngoscopes and COVID-19 testing were available on-site at 17% of respondents' hospitals. Conclusions: At the onset of the COVID-19 epidemic in Lebanon, the availability of recommended PPE to the surveyed ICU physicians in Lebanon and the available ICU resources and COVID-19 preparedness at their hospitals were limited.
ABSTRACT
COVID-19 has taken the whole world by surprise and overnight, we found ourselves at war with an invisible yet ruthless adversary. In Lebanon, representatives from the major medical societies at the forefront of the battle convened and drafted a document to serve as a roadmap towards tackling this pandemic. It involves diagnosis and early recognition of severity as well as potential treatment modalities, emphasizing the protection of healthcare personnel.