Annals of Intensive Care (Oct 2020)
Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy
- Tommaso Tonetti,
- Giacomo Grasselli,
- Alberto Zanella,
- Giacinto Pizzilli,
- Roberto Fumagalli,
- Simone Piva,
- Luca Lorini,
- Giorgio Iotti,
- Giuseppe Foti,
- Sergio Colombo,
- Luigi Vivona,
- Sandra Rossi,
- Massimo Girardis,
- Vanni Agnoletti,
- Anselmo Campagna,
- Giovanni Gordini,
- Paolo Navalesi,
- Annalisa Boscolo,
- Alessandro Graziano,
- Ilaria Valeri,
- Andrea Vianello,
- Danilo Cereda,
- Claudia Filippini,
- Maurizio Cecconi,
- Franco Locatelli,
- Michele Bartoletti,
- Maddalena Giannella,
- Pierluigi Viale,
- Massimo Antonelli,
- Stefano Nava,
- Antonio Pesenti,
- V. Marco Ranieri,
- the COVID-19 Northern Italian ICU Network
Affiliations
- Tommaso Tonetti
- Alma Mater Studiorum, Dipartimento Di Scienze Mediche E Chirurgiche, Anesthesia and Intensive Care Medicine, Università Di Bologna, Policlinico Di Sant’Orsola
- Giacomo Grasselli
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan
- Alberto Zanella
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan
- Giacinto Pizzilli
- Alma Mater Studiorum, Dipartimento Di Scienze Mediche E Chirurgiche, Anesthesia and Intensive Care Medicine, Università Di Bologna, Policlinico Di Sant’Orsola
- Roberto Fumagalli
- Anesthesia and Critical Care, ASST Grande Ospedale Metropolitano Niguarda, University of Milano-Bicocca
- Simone Piva
- Anesthesia and Critical Care, ASST Spedali Civili, University of Brescia
- Luca Lorini
- Anesthesia and Critical Care, ASST Papa Giovanni XXIII
- Giorgio Iotti
- Anesthesia and Critical Care, Fondazione IRCCS Policlinico San Matteo
- Giuseppe Foti
- Anesthesia and Critical Care, ASST Ospedale San Gerardo Di Monza, University of Milano-Bicocca
- Sergio Colombo
- Anesthesia and Critical Care, IRCCS San Raffaele Scientific Institute, Università Vita-Salute San Raffaele
- Luigi Vivona
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan
- Sandra Rossi
- Anesthesia and Critical Care, Azienda Ospedaliero-Universitaria Di Parma
- Massimo Girardis
- Anesthesia and Critical Care, Policlinico Di Modena, Università Di Modena E Reggio Emilia
- Vanni Agnoletti
- Anesthesia and Critical Care Ospedale “M. Bufalini”
- Anselmo Campagna
- Assessorato Cura Della Persona, Regione Emilia-Romagna
- Giovanni Gordini
- Anesthesia and Critical Care Ospedale
- Paolo Navalesi
- Anesthesia and Critical Care, Department of Medicine, DIMED - University of Padua, University Hospital of Padua
- Annalisa Boscolo
- Anesthesia and Critical Care, Department of Medicine, DIMED - University of Padua, University Hospital of Padua
- Alessandro Graziano
- Anesthesia and Critical Care, Department of Medicine, DIMED - University of Padua, University Hospital of Padua
- Ilaria Valeri
- Anesthesia and Critical Care, Department of Medicine, DIMED - University of Padua, University Hospital of Padua
- Andrea Vianello
- Respiratory Pathophysiology Division University-City Hospital of Padua
- Danilo Cereda
- Direzione Generale Welfare, Lombardy Region
- Claudia Filippini
- Dipartimento Di Scienze Chirurgiche, Università Di Torino
- Maurizio Cecconi
- Department of Anesthesia and Intensive Care, Humanitas Clinical and Research Center, Humanitas University
- Franco Locatelli
- Department of Pediatric Hematology and Oncology, Sapienza University of Rome, IRCCS Ospedale Pediatrico Bambino Gesù. President of the “Consiglio Superiore Di Sanità”
- Michele Bartoletti
- Alma Mater Studiorum, Dipartimento Di Scienze Mediche E Chirurgiche, Infectious Diseases Unit, Università Di Bologna, Sant’Orsola-Malpighi Hospital, University of Bologna
- Maddalena Giannella
- Alma Mater Studiorum, Dipartimento Di Scienze Mediche E Chirurgiche, Infectious Diseases Unit, Università Di Bologna, Sant’Orsola-Malpighi Hospital, University of Bologna
- Pierluigi Viale
- Alma Mater Studiorum, Dipartimento Di Scienze Mediche E Chirurgiche, Infectious Diseases Unit, Università Di Bologna, Sant’Orsola-Malpighi Hospital, University of Bologna
- Massimo Antonelli
- Dept. of Intensive Care Emergency Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore
- Stefano Nava
- Department of Clinical, Integrated, and Experimental Medicine (DIMES), Respiratory and Critical Care, Sant’Orsola Malpighi Hospital
- Antonio Pesenti
- Alma Mater Studiorum, Dipartimento Di Scienze Mediche E Chirurgiche, Anesthesia and Intensive Care Medicine, Università Di Bologna, Policlinico Di Sant’Orsola
- V. Marco Ranieri
- Department of Pathophysiology and Transplantation, University of Milan
- the COVID-19 Northern Italian ICU Network
- DOI
- https://doi.org/10.1186/s13613-020-00750-z
- Journal volume & issue
-
Vol. 10,
no. 1
pp. 1 – 8
Abstract
Abstract Background 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. Results 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. Conclusions 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.
Keywords