[Intensive care and Covid]

Abstract

The health crisis linked to COVID-19 has put the whole hospital under stress. Intensive care units (ICU) have been on the front line to manage the most serious cases. The number of new admissions together with cumulative number of occupied intensive care beds have been and still are a key element in measuring the intensity of the crisis. Intensive care is a specialty largely unknown to the general public which is problematic when dealing with such difficult questions as should we give priority to health or to the economy; is there a loss of chance for non-COVID patients due to deprogramming? The increase in the demand for critical care has necessitated an extension of hospitalization capacities by transforming intermediate care beds into ICU beds, by creating neo-ICU, or in some regions by carrying out critical care, usually performed in ICU, in regular wards. Among the several limiting factors, human resources with qualified personnel was a key element together with the relative shortage of drugs. The mismatch between demand and supply has led to the establishment of rules for prioritizing access to ICU. This review deals with all these issues and can contribute to a reflection on the adaptation of the critical care department to cope with major sanitary crisis.

Keywords: Coronavirus Infections; Ethics; Health Services for the Aged; Resuscitation.

Figure 1

Eléments du choix d’orientation des patients. USLD : unité de séjour de longue durée ; SAU : service d’accueil des urgences ; MCO : médecine chirurgie obstétrique ; SOFA : Sequential Organ Failure Asessement ; CFS : Clinical Frailty Scale.