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.
RESUMENMujer de 29 años que desarrolló insidiosamente ascitis y dolor abdominal. El estudio del líquido ascítico reveló su aspecto lechoso y de trasudado. El estudio tomográfico mostró un conglomerado ganglionar retroperitoneal. El CA 125 fue más de cien veces el límite superior normal. El estudio reveló que se trataba de un linfoma no Hodgkin intestinal difuso de células grandes, estirpe linfoide B. (Rev Med Hered 2007;18:155-160).PALABRAS CLAVE: Quiloperitoneo, ascitis quilosa, CA 125, linfoma de células B, linfoma no Hodgkin, linforma intestinal. SUMMARYA 29 year old woman insidiously developed an ascites that was a transudate with "milky" appearance. The CAT study revealed a lymph nodes conglomerate in the retroperitoneal space. CA 125 value was more than a hundredth times the normal upper limit. The study showed a large B-cell diffuse small bowel non-Hodgkin lymphoma. (Rev Med Hered 2007;18:155-160).
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