How the COVID-19 pandemic will change the future of critical care

被引:133
|
作者
Arabi, Yaseen M. [1 ]
Azoulay, Elie [2 ,3 ]
Al-Dorzi, Hasan M. [1 ]
Phua, Jason [4 ]
Salluh, Jorge [5 ,6 ]
Binnie, Alexandra [7 ,8 ]
Hodgson, Carol [9 ,10 ,11 ,12 ]
Angus, Derek C. [13 ]
Cecconi, Maurizio [14 ,15 ]
Du, Bin [16 ,17 ]
Fowler, Rob [18 ,19 ,20 ]
Gomersall, Charles D. [21 ]
Horby, Peter [22 ]
Juffermans, Nicole P. [23 ,24 ]
Kesecioglu, Jozef [25 ]
Kleinpell, Ruth M. [26 ]
Machado, Flavia R. [27 ]
Martin, Greg S. [28 ,29 ]
Meyfroidt, Geert [30 ,31 ]
Rhodes, Andrew [32 ,33 ]
Rowan, Kathryn [34 ]
Timsit, Jean-Francois [35 ]
Vincent, Jean-Louis [36 ]
Citerio, Giuseppe [37 ,38 ]
机构
[1] King Saud Bin Abdulaziz Univ Hlth Sci, Intens Care Dept, King Abdullah Int Med Res Ctr, Minist Natl Guard Hlth Affairs, Riyadh, Saudi Arabia
[2] St Louis Univ Hosp, Med Intens Care Unit, 1 Ave Claude Vellefaux, F-75010 Paris, France
[3] Paris 7 Univ, 1 Ave Claude Vellefaux, F-75010 Paris, France
[4] Natl Univ Hlth Syst, Div Resp & Crit Care Med, FAST & Chron Programmes, Natl Univ Hosp,Alexandra Hosp,Dept Med, Singapore, Singapore
[5] DOr Inst Res & Educ, Dept Crit Care, Rio De Janeiro, Brazil
[6] DOr Inst Res & Educ, Grad Program Translat Med, Rio De Janeiro, Brazil
[7] William Osler Hlth Syst, Crit Care Dept, Etobicoke, ON, Canada
[8] Univ Algarve, Fac Med & Biomed Sci, Faro, Portugal
[9] Australian & New Zealand Intens Care Res Ctr, Melbourne, Vic, Australia
[10] Alfred Hosp, Melbourne, Vic, Australia
[11] Monash Univ, Melbourne, Vic, Australia
[12] Monash Partners Acad, Hlth Sci Ctr, Prahran, Vic, Australia
[13] Univ Pittsburgh, Sch Med, Dept Crit Care Med, Pittsburgh, PA USA
[14] Humanitas Clin & Res Ctr IRCCS, Dept Anaesthesia & Intens Care, Milan, Italy
[15] Humanitas Univ, Dept Biomed Sci, Milan, Italy
[16] Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, State Key Lab Complex Severe & Rare Dis, Beijing, Peoples R China
[17] Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Med ICU, Beijing, Peoples R China
[18] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
[19] Sunnybrook Med Ctr, Dept Crit Care Med, Toronto, ON, Canada
[20] Sunnybrook Med Ctr, Dept Med, Toronto, ON, Canada
[21] Chinese Univ Hong Kong, Dept Anaesthesia & Intens Care, Shatin, Hong Kong, Peoples R China
[22] Univ Oxford, Ctr Trop Med & Global Hlth, Oxford, England
[23] Univ Amsterdam, Med Ctr, Dept Intens Care, OLVG Hosp, Amsterdam, Netherlands
[24] Univ Amsterdam, Med Ctr, Lab Expt Intens Care & Anesthesiol, Amsterdam, Netherlands
[25] Univ Utrecht, Univ Med Ctr Utrecht, Dept Intens Care Med, Utrecht, Netherlands
[26] Vanderbilt Univ, Sch Nursing, 461 21st Ave South, Nashville, TN 37203 USA
[27] Univ Fed Sao Paulo, Anesthesiol Pain & Intens Care Dept, Sao Paulo, Brazil
[28] Emory Univ, Sch Med, Div Pulm Allergy Crit Care & Sleep Med, Emory Crit Care Ctr, Atlanta, GA USA
[29] Grady Mem Hosp, Atlanta, GA USA
[30] Univ Hosp Leuven, Dept & Lab Intens Care Med, Leuven, Belgium
[31] Katholieke Univ Leuven, Leuven, Belgium
[32] St Georges Univ Hosp NHS Fdn Trust, Adult Crit Care, London, England
[33] St Georges Univ London, London, England
[34] Intens Care Natl Audit & Res Ctr ICNARC, Napier House,24 High Holborn, London WC1V 6AZ, England
[35] Univ Paris, Bichat Hosp, AP HP, IAME,INSERM,Med & Infect Dis ICU MI2, F-75018 Paris, France
[36] Univ Libre Bruxelles, Erasme Univ Hosp, Dept Intens Care, Brussels, Belgium
[37] Univ Milano Bicocca, Sch Med & Surg, Monza, Italy
[38] ASST Monza, San Gerardo Hosp, Neurointens Care Unit, Monza, Italy
关键词
COVID-19; Critical care; Technology; Pandemic; Intensive care;
D O I
10.1007/s00134-021-06352-y
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Coronavirus disease 19 (COVID-19) has posed unprecedented healthcare system challenges, some of which will lead to transformative change. It is obvious to healthcare workers and policymakers alike that an effective critical care surge response must be nested within the overall care delivery model. The COVID-19 pandemic has highlighted key elements of emergency preparedness. These include having national or regional strategic reserves of personal protective equipment, intensive care unit (ICU) devices, consumables and pharmaceuticals, as well as effective supply chains and efficient utilization protocols. ICUs must also be prepared to accommodate surges of patients and ICU staffing models should allow for fluctuations in demand. Pre-existing ICU triage and end-of-life care principles should be established, implemented and updated. Daily workflow processes should be restructured to include remote connection with multidisciplinary healthcare workers and frequent communication with relatives. The pandemic has also demonstrated the benefits of digital transformation and the value of remote monitoring technologies, such as wireless monitoring. Finally, the pandemic has highlighted the value of pre-existing epidemiological registries and agile randomized controlled platform trials in generating fast, reliable data. The COVID-19 pandemic is a reminder that besides our duty to care, we are committed to improve. By meeting these challenges today, we will be able to provide better care to future patients.
引用
收藏
页码:282 / 291
页数:10
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