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ICU Bed Utilization During the Coronavirus Disease 2019 Pandemic in a Multistate Analysis-March to June 2020.
Douin, David J; Ward, Michael J; Lindsell, Christopher J; Howell, Michelle P; Hough, Catherine L; Exline, Matthew C; Gong, Michelle N; Aboodi, Michael S; Tenforde, Mark W; Feldstein, Leora R; Stubblefield, William B; Steingrub, Jay S; Prekker, Matthew E; Brown, Samuel M; Peltan, Ithan D; Khan, Akram; Files, D Clark; Gibbs, Kevin W; Rice, Todd W; Casey, Jonathan D; Hager, David N; Qadir, Nida; Henning, Daniel J; Wilson, Jennifer G; Patel, Manish M; Self, Wesley H; Ginde, Adit A.
  • Douin DJ; University of Colorado School of Medicine, Aurora, CO.
  • Ward MJ; Vanderbilt University Medical Center, Nashville, TN.
  • Lindsell CJ; Vanderbilt University Medical Center, Nashville, TN.
  • Howell MP; University of Colorado School of Medicine, Aurora, CO.
  • Hough CL; Oregon Health & Science University School of Medicine, Portland, OR.
  • Exline MC; Ohio State University, Wexner Medical Center, Columbus, OH.
  • Gong MN; Albert Einstein College of Medicine, Bronx, NY.
  • Aboodi MS; Albert Einstein College of Medicine, Bronx, NY.
  • Tenforde MW; CDC COVID-19 Response Team, Atlanta, GA.
  • Feldstein LR; CDC COVID-19 Response Team, Atlanta, GA.
  • Stubblefield WB; Vanderbilt University Medical Center, Nashville, TN.
  • Steingrub JS; Baystate Medical Center, Springfield, MA.
  • Prekker ME; Hennepin County Medical Center, Minneapolis, MN.
  • Brown SM; Intermountain Medical Center and University of Utah School of Medicine, Salt Lake City, UT.
  • Peltan ID; Intermountain Medical Center and University of Utah School of Medicine, Salt Lake City, UT.
  • Khan A; Oregon Health & Science University School of Medicine, Portland, OR.
  • Files DC; Wake Forest University Baptist Medical Center, Winston-Salem, NC.
  • Gibbs KW; Wake Forest University Baptist Medical Center, Winston-Salem, NC.
  • Rice TW; Vanderbilt University Medical Center, Nashville, TN.
  • Casey JD; Vanderbilt University Medical Center, Nashville, TN.
  • Hager DN; Johns Hopkins Hospital, Baltimore, MD.
  • Qadir N; David Geffen School of Medicine at UCLA, Los Angeles, CA.
  • Henning DJ; Harborview Medical Center, Seattle, WA.
  • Wilson JG; Stanford Hospital Medical Center, Palo Alto, CA.
  • Patel MM; CDC COVID-19 Response Team, Atlanta, GA.
  • Self WH; Vanderbilt University Medical Center, Nashville, TN.
  • Ginde AA; University of Colorado School of Medicine, Aurora, CO.
Crit Care Explor ; 3(3): e0361, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1158026
ABSTRACT

OBJECTIVES:

Given finite ICU bed capacity, knowledge of ICU bed utilization during the coronavirus disease 2019 pandemic is critical to ensure future strategies for resource allocation and utilization. We sought to examine ICU census trends in relation to ICU bed capacity during the rapid increase in severe coronavirus disease 2019 cases early during the pandemic.

DESIGN:

Observational cohort study.

SETTING:

Thirteen geographically dispersed academic medical centers in the United States. PATIENTS/

SUBJECTS:

We obtained daily ICU censuses from March 26 to June 30, 2020, as well as prepandemic ICU bed capacities. The primary outcome was daily census of ICU patients stratified by coronavirus disease 2019 and mechanical ventilation status in relation to ICU capacity.

INTERVENTIONS:

None. MEASUREMENTS AND MAIN

RESULTS:

Prepandemic overall ICU capacity ranged from 62 to 225 beds (median 109). During the study period, the median daily coronavirus disease 2019 ICU census per hospital ranged from 1 to 84 patients, and the daily ICU census exceeded overall ICU capacity for at least 1 day at five institutions. The number of critically ill patients exceeded ICU capacity for a median (interquartile range) of 17 (12-50) of 97 days at these five sites. All 13 institutions experienced decreases in their noncoronavirus disease ICU population, whereas local coronavirus disease 2019 cases increased. Coronavirus disease 2019 patients reached their greatest proportion of ICU capacity on April 12, 2020, when they accounted for 44% of ICU patients across all participating hospitals. Maximum ICU census ranged from 52% to 289% of overall ICU capacity, with three sites less than 80%, four sites 80-100%, five sites 100-128%, and one site 289%.

CONCLUSIONS:

From March to June 2020, the coronavirus disease 2019 pandemic led to ICU censuses greater than ICU bed capacity at fives of 13 institutions evaluated. These findings demonstrate the short-term adaptability of U.S. healthcare institutions in redirecting limited resources to accommodate a public health emergency.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Crit Care Explor Year: 2021 Document Type: Article Affiliation country: CCE.0000000000000361

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Crit Care Explor Year: 2021 Document Type: Article Affiliation country: CCE.0000000000000361