Who gets the ventilator? A multicentre survey of intensivists' opinions of triage during the first wave of the COVID-19 pandemic

被引:9
|
作者
Fjolner, Jesper [1 ,2 ,3 ]
Haaland, Oystein Ariandsen [4 ,5 ]
Jung, Christian [6 ]
de Lange, Dylan W. [7 ]
Szczeklik, Wojciech [8 ]
Leaver, Susannah [9 ]
Guidet, Bertrand [10 ,11 ]
Sviri, Sigal [12 ]
Van Heerden, Peter Vernon [13 ,14 ]
Beil, Michael [12 ]
Hartog, Christiane S. [15 ,16 ]
Flaatten, Hans [4 ,17 ]
机构
[1] Viborg Reg Hosp, Dept Anaesthesia & Intens Care, Heibergs Alle 4, DK-8800 Viborg, Denmark
[2] Cent Denmark Reg, Prehosp Emergency Med Serv, Aarhus, Denmark
[3] Aarhus Univ, Dept Clin Med, Aarhus, Denmark
[4] Univ Bergen, Dept Clin Med, Bergen, Norway
[5] Univ Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway
[6] Heinrich Heine Univ Duesseldorf, Med Fac, Dept Cardiol Pulmonol & Vasc Med, Dusseldorf, Germany
[7] Univ Utrecht, Univ Med Ctr, Dept Intens Care Med, Utrecht, Netherlands
[8] Jagiellonian Univ Med Coll, Dept Intens Care & Perioperat Med, Krakow, Poland
[9] St Georges Univ Hosp NHS Fdn Trust, Gen Intens Care, London, England
[10] UPMC Univ Paris 06, Sorbonne Univ, INSERM, UMR S 1136,Inst Pierre Louis Epidemiol & Sante Pu, Paris, France
[11] Hop St Antoine, AP HP, Serv Reanimat Med, Paris, France
[12] Hadassah Univ, Dept Med Intens Care, Med Ctr, Jerusalem, Israel
[13] Hebrew Univ Jerusalem, Hadassah Med Ctr, Gen Intens Care Unit, Jerusalem, Israel
[14] Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel
[15] Charite Univ Med Berlin, Dept Anesthesiol & Intens Care Med, Berlin, Germany
[16] Klin Bavaria, Kreischa, Germany
[17] Haukeland Hosp, Dept Anaesthesia & Intens Care, Bergen, Norway
关键词
COVID-19; pandemic; triage; ventilator allocation; CARE; ICU; ALLOCATION; PHYSICIANS;
D O I
10.1111/aas.14094
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background The COVID-19 pandemic has caused a shortage of intensive care resources. Intensivists' opinion of triage and ventilator allocation during the COVID-19 pandemic is not well described. Methods This was a survey concerning patient numbers, bed capacity, triage guidelines, and three virtual cases involving ventilator allocations. Physicians from 400 ICUs in a research network were invited to participate. Preferences were assessed with a five-point Likert scale. Additionally, age, gender, work experience, geography, and religion were recorded. Results Of 437 responders 31% were female. The mean age was 44.4 (SD 11.1) with a mean ICU experience of 13.7 (SD 10.5) years. Respondents were mostly European (88%). Sixty-six percent had triage guidelines available. Younger patients and caretakers of children were favoured for ventilator allocation although this was less clear if this involved withdrawal of the ventilator from another patient. Decisions did not differ with ICU experience, gender, religion, or guideline availability. Consultation of colleagues or an ethical committee decreased with age and male gender. Conclusion Intensivists appeared to prioritise younger patients for ventilator allocation. The tendency to consult colleagues about triage decreased with age and male gender. Many found such tasks to be not purely medical and that authorities should assume responsibility for triage during resource scarcity.
引用
收藏
页码:859 / 868
页数:10
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