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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.
  • Tonetti T; Alma Mater Studiorum, Dipartimento Di Scienze Mediche E Chirurgiche, Anesthesia and Intensive Care Medicine, Università Di Bologna, Policlinico Di Sant'Orsola, Via Massarenti, 9 40138, Bologna, Italy. tommaso.tonetti@unibo.it.
  • Grasselli G; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
  • Zanella A; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
  • Pizzilli G; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
  • Fumagalli R; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
  • Piva S; Alma Mater Studiorum, Dipartimento Di Scienze Mediche E Chirurgiche, Anesthesia and Intensive Care Medicine, Università Di Bologna, Policlinico Di Sant'Orsola, Via Massarenti, 9 40138, Bologna, Italy.
  • Lorini L; Anesthesia and Critical Care, ASST Grande Ospedale Metropolitano Niguarda, University of Milano-Bicocca, Milan, Italy.
  • Iotti G; Anesthesia and Critical Care, ASST Spedali Civili, University of Brescia, Brescia, Italy.
  • Foti G; Anesthesia and Critical Care, ASST Papa Giovanni XXIII, Bergamo, Italy.
  • Colombo S; Anesthesia and Critical Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • Vivona L; Anesthesia and Critical Care, ASST Ospedale San Gerardo Di Monza, University of Milano-Bicocca, Milan, Italy.
  • Rossi S; Anesthesia and Critical Care, IRCCS San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milan, Italy.
  • Girardis M; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
  • Agnoletti V; Anesthesia and Critical Care, Azienda Ospedaliero-Universitaria Di Parma, Parma, Italy.
  • Campagna A; Anesthesia and Critical Care, Policlinico Di Modena, Università Di Modena E Reggio Emilia, Modena, Italy.
  • Gordini G; Anesthesia and Critical Care Ospedale "M. Bufalini", Cesena, Italy.
  • Navalesi P; Assessorato Cura Della Persona, Regione Emilia-Romagna, Salute e Walfare, Bologna, Italy.
  • Boscolo A; Anesthesia and Critical Care Ospedale, Ospedale Maggiore, Bologna, Italy.
  • Graziano A; Anesthesia and Critical Care, Department of Medicine, DIMED - University of Padua, University Hospital of Padua, Padua, Italy.
  • Valeri I; Anesthesia and Critical Care, Department of Medicine, DIMED - University of Padua, University Hospital of Padua, Padua, Italy.
  • Vianello A; Anesthesia and Critical Care, Department of Medicine, DIMED - University of Padua, University Hospital of Padua, Padua, Italy.
  • Cereda D; Anesthesia and Critical Care, Department of Medicine, DIMED - University of Padua, University Hospital of Padua, Padua, Italy.
  • Filippini C; Respiratory Pathophysiology Division University-City Hospital of Padua, Padua, Italy.
  • Cecconi M; Direzione Generale Welfare, Lombardy Region, Milan, Italy.
  • Locatelli F; Dipartimento Di Scienze Chirurgiche, Università Di Torino, Torino, Italy.
  • Bartoletti M; Department of Anesthesia and Intensive Care, Humanitas Clinical and Research Center, Humanitas University, Milan, Italy.
  • Giannella M; Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy.
  • Viale P; Department of Pediatric Hematology and Oncology, Sapienza University of Rome, IRCCS Ospedale Pediatrico Bambino Gesù. President of the "Consiglio Superiore Di Sanità", Rome, Italy.
  • Antonelli M; Alma Mater Studiorum, Dipartimento Di Scienze Mediche E Chirurgiche, Infectious Diseases Unit, Università Di Bologna, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
  • Nava S; Alma Mater Studiorum, Dipartimento Di Scienze Mediche E Chirurgiche, Infectious Diseases Unit, Università Di Bologna, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
  • Pesenti A; Alma Mater Studiorum, Dipartimento Di Scienze Mediche E Chirurgiche, Infectious Diseases Unit, Università Di Bologna, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
  • Ranieri VM; Dept. of Intensive Care Emergency Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Ann Intensive Care ; 10(1): 133, 2020 Oct 12.
Article in English | MEDLINE | ID: covidwho-846400
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. 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. 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. 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.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study Language: English Journal: Ann Intensive Care Year: 2020 Document Type: Article Affiliation country: S13613-020-00750-z

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study Language: English Journal: Ann Intensive Care Year: 2020 Document Type: Article Affiliation country: S13613-020-00750-z