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Review
. 2022 Dec 1;28(6):638-644.
doi: 10.1097/MCC.0000000000001001. Epub 2022 Oct 11.

Surging ICU during COVID-19 pandemic: an overview

Yaseen M Arabi  1 , Sheila Nainan Myatra  2 , Suzana M Lobo  3
Affiliations
Review

Surging ICU during COVID-19 pandemic: an overview

Yaseen M Arabi et al. Curr Opin Crit Care. .

Abstract

Purpose of review: The coronavirus disease 2019 (COVID-19) pandemic has posed great challenges to intensive care units (ICUs) across the globe. The objective of this review is to provide an overview on how ICU surging was managed during COVID-19 pandemic, with a special focus on papers published in the last 18 months.

Recent findings: From the onset of the COVID-19 pandemic, it was apparent that the biggest challenge was the inequity of access to an adequately equipped and staffed ICU bed. The first wave was overwhelming; large surge of patients required critical care, resources were limited and non-COVID-19 care processes were severely compromised. Various approaches were used to address ICU staffing shortage and to expand the physical ICU space capacity. Because of restrictions to family visitations in most ICUs, the pandemic posed a threat to communication and family-centered ICU care. The pandemic, especially during the first wave, was accompanied by a high level of apprehension in the community, many uncertainties about clinical course and therapy and an influx of speculations and misinformation.

Summary: Although healthcare systems learned how to face some of the challenges with subsequent waves, the pandemic had persistent effects on healthcare systems.

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Conflict of interest statement

Y.A. is an investigator on the REMAP-CAP trial and is a board member of the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC).

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References

    1. French G, Hulse M, Nguyen D, et al. . Impact of hospital strain on excess deaths during the COVID-19 pandemic − United States, July 2020−July 2021. MMWR Morbid Mortal wkly Rep 2021; 70:1613–1616. - PMC - PubMed
    1. Greco M, De Corte T, Ercole A, et al. . Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study. Intensive Care Med 2022; 48:690–705. - PMC - PubMed

    2. This was multicenter, international, point prevalence study of adult patients with COVID-19 admitted to ICUs between February 15th and May 15th, 2020. 4994 patients from 280 ICUs in 46 countries were included. The study demonstrated that ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. In this study, admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality.

    1. Kerlin MP, Costa DK, Davis BS, et al. . Actions taken by US hospitals to prepare for increased demand for intensive care during the first wave of COVID-19: a national survey. Chest 2021; 160:519–528. - PMC - PubMed

    2. This study evaluated what actions did US hospitals take to prepare for a potential surge in demand for critical care services in the context of the COVID-19 pandemic.

    1. Vranas KC, Golden SE, Mathews KS, et al. . The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study. Chest 2021; 160:1714–1728. - PMC - PubMed
    1. Mathews KS, Seitz KP, Vranas KC, et al. . Variation in initial U.S. hospital responses to the coronavirus disease 2019 pandemic. Crit Care Med 2021; 49:1038–1048. - PMC - PubMed