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Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy

2020; Springer Nature; Volume: 10; Issue: 1 Linguagem: Inglês

10.1186/s13613-020-00750-z

2110-5820

Tommaso Tonetti, Giacomo Grasselli, Alberto Zanella, Giacinto Pizzilli, Roberto Fumagalli, Simone Piva, Ferdinando Luca Lorini, Giorgio Antonio Iotti, Giuseppe Foti, Sergio Colombo, Luigi Vivona, Sandra Rossi, Massimo Girardis, Vanni Agnoletti, Anselmo Campagna, Giovanni Gordini, Paolo Navalesi, Annalisa Boscolo, Alessandro Di Graziano, Ilaria Valeri, Andrea Vianello, Danilo Cereda, Claudia Filippini, Maurizio Cecconi, Franco Locatelli, Michele Bartoletti, Maddalena Giannella, Pierluigi Viale, Massimo Antonelli, Stefano Nava, Antonio Artigas, V. Marco Ranieri, Giovanni Albano, Armando Alborghetti, Giorgio Aldegheri, Benvenuto Antonini, Nicolangela Belgiorno, Giacomo Bellani, Enrico Beretta, Stefano Bonazzi, Massimo Borelli, Luca Cabrini, Livio Carnevale, Sergio Carnevale, Gianpaolo Castelli, E Catena, Davide Chiumello, Antonio Coluccello, Davide Coppini, Daniel Covello, Gianluca De Filippi, Marco Poli, Paolo Dughi, G Gallioli, Paolo Gnesin, Massimiliano Greco, Luca Guatteri, Davide Guzzon, Roberto Keim, Giovanni Landoni, Thomas Länger, Andrea Lombardo, Giovanni Marino, Guido Merli, Dario Merlo, Francesco Mojoli, Stefano Muttini, Giuseppe Natalini, Nicola Petrucci, Angelo Pezzi, Danilo Radrizzani, Maurizio Raimondi, Mario Riccio, Enrico Storti, Mario Tavola, Giovanni Vitale, Enrico Bosco, Mauro Antonio Calò, Vinicio Danzi, Silvia De Rosa, Antonio Farnia, Francesco Lazzari, Marco Meggiolaro, Marina Munari, Mario Saïa, Nicolò Sella, Eugenio Serra, Ivo Tiberio, Massimo Baiocchi, Maria Benedetto, Martina Bordini, Fabio Caramelli, Nicola Cilloni, Maria Della Giovampaola, Andrea Fanelli, Guido Frascaroli, Maurizio Fusari, Giovanni Gordini, Stefano Maitan, Costanza Martino, Rita Maria Melotti, Raffaele Merola, Francesco Minardi, Federico Moro, Giuseppe Nardi, Massimo Nolli, Elisabetta Pierucci, Antonella Potalivo, Francesca Repetti, Pierpaolo Salsi, Marina Terzitta, Martina Tosi, Sergio Venturi, Carlo Alberto Volta, Gianluca Zani, Andrea Zanoni,

Respiratory Support and Mechanisms

A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary.In order to evaluate the impact of Covid-19 on the ICU capacity to manage critically ill patients, we performed a retrospective analysis of the first 2 weeks of the outbreak (February 24-March 8). Data were collected from regional registries and from a case report form sent to participating sites. ICU beds increased from 1545 to 1989 (28.7%), and patients receiving respiratory support outside the ICU increased from 4 (0.6%) to 260 (37.0%). Patients receiving respiratory support outside the ICU were significantly older [65 vs. 77 years], had more cerebrovascular (5.8 vs. 13.1%) and renal (5.3 vs. 10.0%) comorbidities and less obesity (31.4 vs. 15.5%) than patients admitted to the ICU. PaO2/FiO2 ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO2 and base excess were lower [34 vs. 42 mmHg; 0.60 vs. 1.30] in patients receiving respiratory support outside the ICU than in patients admitted to the ICU, respectively.Increase in ICU beds and use of out-of-ICU respiratory support allowed effective management of the first 14 days of the Covid-19 outbreak, avoiding resource rationing.