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. 2021 Jul 13;21(1):228.
doi: 10.1186/s12890-021-01593-5.

Role of respiratory intermediate care units during the SARS-CoV-2 pandemic

Mónica Matute-Villacís  1 , Jorge Moisés  1   2 , Cristina Embid  1   2 , Judith Armas  1 , Isabel Fernández  1 , Montserrat Medina  1 , Miquel Ferrer  1   2 , Oriol Sibila  1   2 , Joan Ramón Badia  3   4
Affiliations

Role of respiratory intermediate care units during the SARS-CoV-2 pandemic

Mónica Matute-Villacís et al. BMC Pulm Med. .

Abstract

Rationale: The SARS-CoV2 pandemic increased exponentially the need for both Intensive (ICU) and Intermediate Care Units (RICU). The latter are of particular importance because they can play a dual role in critical and post-critical care of COVID-19 patients. Here, we describe the setup of 2 new RICUs in our institution to face the SARS-CoV-2 pandemic and discuss the clinical characteristics and outcomes of the patients attended.

Methods: Retrospective analysis of the characteristics and outcomes of COVID-19 patients admitted to 2 new RICUs built specifically in our institution to face the first wave of the SARS-CoV-2 pandemic, from April 1 until May 30, 2020.

Results: During this period, 106 COVID-19 patients were admitted to these 2 RICUs, 65 of them (61%) transferred from an ICU (step-down) and 41 (39%) from the ward or emergency room (step-up). Most of them (72%) were male and mean age was 66 ± 12 years. 31% of them required support with oxygen therapy via high-flow nasal cannula (HFNC) and 14% non-invasive ventilation (NIV). 42 of the 65 patients stepping down (65%) had a previous tracheostomy performed and most of them (74%) were successfully decannulated during their stay in the RICU. Length of stay was 7 [4-11] days. 90-day mortality was 19% being significantly higher in stepping up patients than in those transferred from the ICU (25 vs. 10% respectively; p < 0.001).

Conclusions: RICUs are a valuable hospital resource to respond to the challenges of the SARS-CoV-2 pandemic both to treat deteriorating and recovering COVID-19 patients.

Keywords: COVID-19; Intensive care; Intermediate care; RICU; Respiratory failure; SARS-CoV-2; Tracheostomy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Functional organizational of Unit A. For further explanations, see text
Fig. 2
Fig. 2
Organizational pyramid of staff in the two RICUs. Modified from the Ontario Health Plan for an Influenza Pandemic Workgroup. For further explanations, see text
Fig. 3
Fig. 3
Kaplan Meier 90-day mortality curves in patients admitted to the RICU from an ICU or non-ICU (ward, ER) settings. For further explanations, see text
See this image and copyright information in PMC

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