scholarly journals Outcomes of critically ill COVID-19 patients managed in a high-volume severe respiratory failure and ECMO centre in the United Kingdom

2020 ◽  
pp. 175114372097885
Author(s):  
Peter B Sherren ◽  
Luigi Camporota ◽  
Barnaby Sanderson ◽  
Andrew Jones ◽  
Manu Shankar-Hari ◽  
...  
Keyword(s):  
Critical Care ◽  
Respiratory Failure ◽  
Clinical Pathways ◽  
Care Service ◽  
High Volume ◽  
Organ Support ◽  
Pulmonary Mechanics ◽  
Critical Care Service ◽  
Local Resources ◽  
The United Kingdom

During the Coronavirus Disease 2019 (COVID-19) pandemic institutions have needed to develop pragmatic clinical pathways to balance the excess critical care demand and local resources. In this single-centre retrospective cohort study we describe the outcomes of COVID-19 patients admitted to Guy’s and St. Thomas’ NHS Foundation Trust (GSTT) critical care service. Patients were managed according to a local respiratory failure management pathway that was predicated on timely invasive ventilation when indicated and tailored ventilatory strategies according to pulmonary mechanics. Between 2 March and 25 May 2020 GSTT critical care service admitted 316 patients with confirmed COVID-19. Of the 201 patients admitted directly through the Emergency Department (ED) with a completed critical care outcome, 71.1% survived to critical care discharge. These favourable outcomes may serve to inform the wider debate on optimal organ support in COVID-19.

scholarly journals Can Ventilatory Strategies in COVID-19 Have an Impact on Outcomes?

2020 ◽  
Author(s):  
Peter Sherren ◽  
Luigi Camporota ◽  
Barnaby Sanderson ◽  
Andrew Jones ◽  
Manu Shankar-Hari ◽  
...  
Keyword(s):  
Critical Care ◽  
Respiratory Failure ◽  
Care Service ◽  
Pulmonary Mechanics ◽  
Invasive Ventilation ◽  
Single Centre ◽  
Limited Disease ◽  
Critical Care Service ◽  
Ventilatory Management ◽  
Care Outcome

The rapidly evolving understanding of Coronavirus Disease 2019 (COVID-19) respiratory failure pathogenesis, limited disease-specific evidence and demand-resource imbalances have posed significant challenges for intensive care clinicians. In this single-centre retrospective cohort study we describe the outcomes of COVID-19 patients admitted to Guy’s and St. Thomas’ NHS Foundation Trust (GSTT) critical care service. Patients were managed according to a local respiratory failure management pathway that was predicated on timely invasive ventilation when indicated and tailored ventilatory strategies according to pulmonary mechanics. Between 2nd March and 25th May 2020 GSTT critical care service admitted 316 patients with confirmed COVID-19. Of the 201 patients admitted directly through the Emergency Department with a completed critical care outcome, 71.1% survived to critical care discharge. These favourable outcomes may serve to inform the wider debate on the optimal ventilatory management in COVID-19.

scholarly journals Telemedicine coverage for post-operative ICU patients

2016 ◽  
Vol 23 (2) ◽  
pp. 360-364 ◽  
Author(s):  
Tara Ann Collins ◽  
Matthew P Robertson ◽  
Corinna P Sicoutris ◽  
Michael A Pisa ◽  
Daniel N Holena ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Care Service ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Surge Capacity ◽  
Icu Patients ◽  
Critical Care Service ◽  
Surgical Critical Care

Introduction There is an increased demand for intensive care unit (ICU) beds. We sought to determine if we could create a safe surge capacity model to increase ICU capacity by treating ICU patients in the post-anaesthesia care unit (PACU) utilizing a collaborative model between an ICU service and a telemedicine service during peak ICU bed demand. Methods We evaluated patients managed by the surgical critical care service in the surgical intensive care unit (SICU) compared to patients managed in the virtual intensive care unit (VICU) located within the PACU. A retrospective review of all patients seen by the surgical critical care service from January 1st 2008 to July 31st 2011 was conducted at an urban, academic, tertiary centre and level 1 trauma centre. Results Compared to the SICU group ( n = 6652), patients in the VICU group ( n = 1037) were slightly older (median age 60 (IQR 47–69) versus 58 (IQR 44–70) years, p = 0.002) and had lower acute physiology and chronic health evaluation (APACHE) II scores (median 10 (IQR 7–14) versus 15 (IQR 11–21), p < 0.001). The average amount of time patients spent in the VICU was 13.7 + /–9.6 hours. In the VICU group, 750 (72%) of patients were able to be transferred directly to the floor; 287 (28%) required subsequent admission to the surgical intensive care unit. All patients in the VICU group were alive upon transfer out of the PACU while mortality in the surgical intensive unit cohort was 5.5%. Discussion A collaborative care model between a surgical critical care service and a telemedicine ICU service may safely provide surge capacity during peak periods of ICU bed demand. The specific patient populations for which this approach is most appropriate merits further investigation.

scholarly journals 167: NURSING EXPERIENCES OF NOVEL SURGICAL CRITICAL CARE SERVICE IMPLEMENTATION DURING COVID-19 PANDEMIC

2021 ◽  
Vol 50 (1) ◽  
pp. 67-67
Author(s):  
Elizabeth Sheridan ◽  
Niels Martin ◽  
Melissa Dunlop ◽  
Jason Saucier ◽  
Christopher Huot ◽  
...  
Keyword(s):  
Critical Care ◽  
Care Service ◽  
Critical Care Service ◽  
Surgical Critical Care
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