COVID-19 Pandemic and the Critical Patient: Experience of Treating Patients in a PACU Converted into an ICU versus Patient Treated in an ICU

Authors

  • Miguel Valente Serviço de Anestesiologia, Centro Hospitalar Universitário São João, Porto, Portugal. https://orcid.org/0000-0002-2083-0680
  • João Oliveira Serviço de Medicina Intensiva, Centro Hospitalar Universitário do Algarve, Faro, Portugal. https://orcid.org/0000-0001-9004-5429
  • Tiago Barbosa Serviço de Anestesiologia, Centro Hospitalar Universitário São João, Porto, Portugal https://orcid.org/0000-0002-6399-3260
  • Sofia Ribeiro Serviço de Medicina Intensiva, Centro Hospitalar Universitário do Algarve, Faro, Portugal https://orcid.org/0000-0001-8075-220X
  • Daniel Nuñez Serviço de Medicina Intensiva, Centro Hospitalar Universitário do Algarve, Faro, Portugal; CRITICALMED - Center for Health Technology and Services Research (CINTESIS), University of Porto, Porto, Portugal https://orcid.org/0000-0002-9763-0337
  • Alice Santos Serviço de Anestesiologia, Centro Hospitalar Universitário São João, Porto, Portugal https://orcid.org/0000-0001-8115-7090
  • Isabel Pereira Serviço de Medicina Intensiva, Centro Hospitalar Universitário do Algarve, Faro, Portugal; CRITICALMED - Center for Health Technology and Services Research (CINTESIS), University of Porto, Porto, Portugal https://orcid.org/0000-0002-7415-2133

DOI:

https://doi.org/10.25751/rspa.20379

Keywords:

COVID-19, SARS-CoV 2, Critical Care, Intensive Care Units, Perioperative Care, Recovery Room

Abstract

Introduction: In December 2019, a new coronavirus was described in China, causing the disease called COVID-19. In Portugal, the health system was forced to review his catastrophe response by expanding the global number of level III intensive care units (ICU) beds. Little is known about the impact that these adaptations have. Therefore, the authors carried out a comparative study of patients admitted in two units.

Methodology: A retrospective observational study was developed in two units, an Intensive Care Unit dedicated to patients with COVID-19 and a Post Anesthetic Care Unit (PACU) converted into a COVID-ICU.

Results: 23 patients with SARS-CoV-2 pneumonia were admitted in unit 1, 11 in Unit 2. SAPS II was similar, but there was a significant difference in SOFA at admission (p=0.025). There was a significant difference in the number of acute respiratory distress syndrome (p=0.036) and the length of stay in the ICU (p=0.045). Mortality in the ICU (p=0.120) and at 28 days (p=0.116) was similar.

Discussion: The differences found between the Sequential Organ Failure Assessment (SOFA) score and the Simplified Acute Physiology Score (SAPS) can be explained by the severity of respiratory dysfunction. The severity of respiratory dysfunction, infectious complications and the profile of patients admitted to the units (level II + III and level III) can contribute to the difference in hospital stay. Mortality after 28 days was lower in Unit 1 (13% vs 36.4%), but without statistical significance.

Conclusion: The results found are globally similar. The team constitution with elements with different experiences and training seems to be a viable alternative during the pandemia.

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Published

2020-08-23

How to Cite

Valente, M., Oliveira, J., Barbosa, T., Ribeiro, S., Nuñez, D., Santos, A., & Pereira, I. (2020). COVID-19 Pandemic and the Critical Patient: Experience of Treating Patients in a PACU Converted into an ICU versus Patient Treated in an ICU. Journal of the Portuguese Society of Anesthesiology, 29(2), 62–67. https://doi.org/10.25751/rspa.20379

Issue

Vol. 29 No. 2 (2020): Revista da Sociedade Portuguesa de Anestesiologia

Section

Original Article

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