Effectiveness of Intermediate Respiratory Care Units as an Alternative to Intensive Care Units during the COVID-19 Pandemic in Catalonia

Effectiveness of Intermediate Respiratory Care Units as an Alternative to Intensive Care Units during the COVID-19 Pandemic in Catalonia

Objectives: During the COVID-19 pandemic, the risk of collapse for the health system created great difficulties. We will demonstrate that intermediate respiratory care units (IRCU) provide adequate management of patients with non-invasive respiratory support, which is particularly important for pati...

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Bibliographic Details
Published in:International journal of environmental research and public health 2022-05, Vol.19 (10), p.6034
Main Authors: Galdeano Lozano, Marina, Alfaro Álvarez, Julio César, Parra Macías, Núria, Salas Campos, Rosario, Heili Frades, Sarah, Montserrat, Josep Maria, Rosell Gratacós, Antoni, Abad Capa, Jorge, Parra Ordaz, Olga, López Seguí, Francesc
Format: Article
Language:eng
Subjects:
Aged
Chronic obstructive pulmonary disease
Comorbidity
Coronaviruses
Cost control
COVID-19
COVID-19 - epidemiology
Critical care
Drug therapy
Ethics
Fever
Hospitals
Humans
Hypertension
Intensive care
Intensive Care Units
Mortality
Oxygen therapy
Pandemics
Patients
Pharmacology
Pneumonia
Respiratory Care Units
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Spain - epidemiology
Statistical analysis
Steroids
Thoracic surgery
Ventilators
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Summary:Objectives: During the COVID-19 pandemic, the risk of collapse for the health system created great difficulties. We will demonstrate that intermediate respiratory care units (IRCU) provide adequate management of patients with non-invasive respiratory support, which is particularly important for patients with SARS-CoV-2 pneumonia. Methods: A prospective observational study of patients with COVID-19 admitted to the ICU of a tertiary hospital. Sociodemographic data, comorbidities, pharmacological, respiratory support, laboratory and blood gas variables were collected. The overall cost of the unit was subsequently analyzed. Results: 991 patients were admitted, 56 to the IRCU (from a of 81 admitted to the critical care unit). Mean age was 65 years (SD 12.8), Barthel index 75 (SD 8.3), Charlson comorbidity index 3.1 (SD 2.2), HTN 27%, COPD 89% and obesity 24%. A significant relationship (p < 0.05) with higher mortality was noted for the following parameters: fever greater than or equal to 39 °C [OR 5.6; 95% CI (1.2−2.7); p = 0.020], protocolized pharmacological treatment [OR 0.3; 95% CI (0.1−0.9); p = 0.023] and IOI [OR 3.7; 95% CI (1.1−12.3); p = 0.025]. NIMV had less of a negative impact [OR 1.8; 95% CI (0.4−8.4); p = 0.423] than IOI. The total cost of the IRCU amounted to €66,233. The cost per day of stay in the IRCU was €164 per patient. The total cost avoided was €214,865. Conclusions: The pandemic has highlighted the importance of IRCUs in facilitating the management of a high patient volume. The treatment carried out in IRCUs is effective and efficient, reducing both admissions to and stays in the ICU.
ISSN:1660-4601
1661-7827
1660-4601