Corinna N Lang1,2, Viviane Zotzmann1,2, Bonaventura Schmid3, Michael Berchtold-Herz4, Stefan Utzolino5, Paul Biever1,2, Daniel Duerschmied1,2, Christoph Bode1,2, Tobias Wengenmayer1,2, Dawid L Staudacher1,2. 1. Department of Cardiology and Angiology I (Heart Center Freiburg University - Bad Krozingen), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU. 2. Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU. 3. Department of Emergency Medicine, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU. 4. Department of Cardiovascular Surgery (Heart Center Freiburg University - Bad Krozingen), Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU. 5. Department of General and Visceral Surgery, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, DEU.
Abstract
BACKGROUND: Germany reported sufficient intensive care unit (ICU) resources throughout the first wave of coronavirus disease 2019 (COVID-19). The treatment of critically ill COVID-19 patients without rationing may improve the outcome. We therefore analyzed ICU resources allocated to COVID-19 patients with respiratory failure and their outcomes. METHODS: Retrospectively, we enrolled severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR)-positive patients with respiratory failure from 03/08/2020 to 04/08/2020 and followed until 05/28/2020 in the university hospital of Freiburg, Germany. RESULTS: In the defined interval, 34 COVID-19 patients were admitted to the ICU with median age of 67±13 (31-86) years. Six of 34 (17.6%) were female. All patients suffered from moderate or severe acute respiratory distress syndrome (ARDS), 91.2% of the patients were intubated and 23.5% required extracorporeal membrane oxygenation (ECMO). Proning was performed in 67.6%, renal replacement therapy (RRT) was required in 35.3%. Ninety-six percent required more than 20 nursing hours per day. Mean ICU stay was 21±19 (1-81) days. Sixty-day survival of critically ill COVID-19 patients was 50.0% (17/34). Causes of death were multi-organ failure (52.9%), refractory ARDS (17.6%) and intracerebral hemorrhage (17.6%). CONCLUSIONS: Treatment of critically ill COVID-19 patients is protracted and resource-intense. In a context without resources shortage, 50% of COVID-19 with respiratory failure survived up to 60 days.
BACKGROUND: Germany reported sufficient intensive care unit (ICU) resources throughout the first wave of coronavirus disease 2019 (COVID-19). The treatment of critically illCOVID-19patients without rationing may improve the outcome. We therefore analyzed ICU resources allocated to COVID-19patients with respiratory failure and their outcomes. METHODS: Retrospectively, we enrolled severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR)-positive patients with respiratory failure from 03/08/2020 to 04/08/2020 and followed until 05/28/2020 in the university hospital of Freiburg, Germany. RESULTS: In the defined interval, 34 COVID-19patients were admitted to the ICU with median age of 67±13 (31-86) years. Six of 34 (17.6%) were female. All patients suffered from moderate or severe acute respiratory distress syndrome (ARDS), 91.2% of the patients were intubated and 23.5% required extracorporeal membrane oxygenation (ECMO). Proning was performed in 67.6%, renal replacement therapy (RRT) was required in 35.3%. Ninety-six percent required more than 20 nursing hours per day. Mean ICU stay was 21±19 (1-81) days. Sixty-day survival of critically illCOVID-19patients was 50.0% (17/34). Causes of death were multi-organ failure (52.9%), refractory ARDS (17.6%) and intracerebral hemorrhage (17.6%). CONCLUSIONS: Treatment of critically illCOVID-19patients is protracted and resource-intense. In a context without resources shortage, 50% of COVID-19 with respiratory failure survived up to 60 days.
Authors: Achim Jörres; Stefan John; Andrew Lewington; Pieter M ter Wee; Raymond Vanholder; Wim Van Biesen; James Tattersall Journal: Nephrol Dial Transplant Date: 2013-10-11 Impact factor: 5.992
Authors: Jan Máca; Ondřej Jor; Michal Holub; Peter Sklienka; Filip Burša; Michal Burda; Vladimír Janout; Pavel Ševčík Journal: Respir Care Date: 2016-11-01 Impact factor: 2.258
Authors: Kenneth Rockwood; Xiaowei Song; Chris MacKnight; Howard Bergman; David B Hogan; Ian McDowell; Arnold Mitnitski Journal: CMAJ Date: 2005-08-30 Impact factor: 8.262
Authors: V Marco Ranieri; Gordon D Rubenfeld; B Taylor Thompson; Niall D Ferguson; Ellen Caldwell; Eddy Fan; Luigi Camporota; Arthur S Slutsky Journal: JAMA Date: 2012-06-20 Impact factor: 56.272
Authors: Konstantinos Raymondos; Tamme Dirks; Michael Quintel; Ulrich Molitoris; Jörg Ahrens; Thorben Dieck; Kai Johanning; Dietrich Henzler; Rolf Rossaint; Christian Putensen; Hermann Wrigge; Ralph Wittich; Maximilian Ragaller; Thomas Bein; Martin Beiderlinden; Maxi Sanmann; Christian Rabe; Jörn Schlechtweg; Monika Holler; Fernando Frutos-Vivar; Andres Esteban; Hartmut Hecker; Simone Rosseau; Vera von Dossow; Claudia Spies; Tobias Welte; Siegfried Piepenbrock; Steffen Weber-Carstens Journal: Crit Care Date: 2017-05-30 Impact factor: 9.097
Authors: Alexander Supady; J Randall Curtis; Darryl Abrams; Roberto Lorusso; Thomas Bein; Joachim Boldt; Crystal E Brown; Daniel Duerschmied; Victoria Metaxa; Daniel Brodie Journal: Lancet Respir Med Date: 2021-01-12 Impact factor: 30.700
Authors: Pavan K Bhatraju; Bijan J Ghassemieh; Michelle Nichols; Richard Kim; Keith R Jerome; Arun K Nalla; Alexander L Greninger; Sudhakar Pipavath; Mark M Wurfel; Laura Evans; Patricia A Kritek; T Eoin West; Andrew Luks; Anthony Gerbino; Chris R Dale; Jason D Goldman; Shane O'Mahony; Carmen Mikacenic Journal: N Engl J Med Date: 2020-03-30 Impact factor: 91.245
Authors: Waleed Alhazzani; Morten Hylander Møller; Yaseen M Arabi; Mark Loeb; Michelle Ng Gong; Eddy Fan; Simon Oczkowski; Mitchell M Levy; Lennie Derde; Amy Dzierba; Bin Du; Michael Aboodi; Hannah Wunsch; Maurizio Cecconi; Younsuck Koh; Daniel S Chertow; Kathryn Maitland; Fayez Alshamsi; Emilie Belley-Cote; Massimiliano Greco; Matthew Laundy; Jill S Morgan; Jozef Kesecioglu; Allison McGeer; Leonard Mermel; Manoj J Mammen; Paul E Alexander; Amy Arrington; John E Centofanti; Giuseppe Citerio; Bandar Baw; Ziad A Memish; Naomi Hammond; Frederick G Hayden; Laura Evans; Andrew Rhodes Journal: Intensive Care Med Date: 2020-03-28 Impact factor: 17.440