Recommendations for the management of critically ill patients with COVID-19 in Intensive Care Units

Two years after the COVID-19 pandemic, many uncertainties persist about the causal agent, the disease and its future. This document contains the reflection of the COVID-19 working group of the Official College of Physicians of Madrid (ICOMEM) in relation to some questions that remain unresolved. The document includes considerations on the origin of the virus, the current indication for diagnostic tests, the value of severity scores in the onset of the disease and the added risk posed by hypertension or dementia. We also discuss the possibility of deducing viral behavior from the examination of the structure of the complete viral genome, the future of some drug associations and the current role of therapeutic resources such as corticosteroids or extracorporeal oxygenation (ECMO). We review the scarce existing information on the reality of COVID 19 in Africa, the uncertainties about the future of the pandemic and the status of vaccines, and the data and uncertainties about the long-term pulmonary sequelae of those who suffered severe pneumonia.

Section: What Is the Role Of Extracorporeal Membrane Oxygenation (Ecm...mentioning

confidence: 99%

Section: What Is the Role Of Extracorporeal Membrane Oxygenation (Ecm...mentioning

confidence: 99%

COVID-19: Some unresolved issues

Gómez-Pavón¹,

Castillo²,

Martín-Delgado³

et al. 2022

“…• Ahondar en las causas y en los motivos por los que la población decide no vacunarse, para plantear posteriores intervenciones, incidiendo en esos motivos para conocer el impacto en la vacunación. En esta línea, y de acuerdo con las propuestas de la OMS [66], sería importante realizar estudios coste-beneficio de la vacunación y dar a conocer a la población general los costes asociados a la morbimortalidad asociada a la gripe y el ahorro estimado de los casos evitados gracias a la vacuna.…”

Section: Propuestas De Medidas Para Mejorar Las Coberturas Vacunales ...unclassified

Untitled

2022

“…The pandemic has generated a heavy overload for ICU medical staff, both as individual [ 10 ] (professionals suffered from significant work and emotional overload, together with the scientific uncertainty of treating a previously unknown disease), as a group (each unit drew up its own organizational response to maximize available resources), and also in institutional terms: the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) and its working groups drew up various documents [ 11 – 20 ] and organized different training activities for their dissemination.…”

Section: Introductionmentioning

confidence: 99%

Impact of one year of pandemic on Spanish Intensive Care Units

Vidal-Cortés¹,

Martín²,

Dı́az³

et al. 2022

Objective. To measure the impact of the pandemic in Spanish ICUs. Material and methods. On-line survey, conducted in April 2021, among SEMICYUC members. Participants were asked about number of patients admitted, increase in the number of beds and staff, structures created in the hospital and self-assessment of the work performed. Results. We received 246 answers from 157 hospitals. 67.7% of the ICUs were expanded during the pandemic, overall increase in beds of 58.6%. The ICU medical staff increased by 6.1% and there has been a nursing shortage in 93.7% of units. Patients exceeded 200% the pre-pandemic ICU capacity. In 88% of the hospitals the collaboration of other specialists was necessary. The predominant collaboration model consisted of the intensive care medicine specialist being responsible for triage and coordinating patient management. Despite that 53.2% centres offered training for critical care, a deterioration in the quality of care was perceived. 84.2% hospitals drew up a Contingency Plan and in 77.8% of the hospitals a multidisciplinary committee was set up to agree on decision-making. Self-evaluation of the work performed was outstanding and 91.9% felt proud of what they had achieved, however, up to 15% considered leaving their job. Conclusions. The Spanish ICUs assumed an unprecedented increase in the number of patients. They achieved it without hardly increasing their staff and, while intensive care medicine training was carried out for other specialists who collaborated. The degree of job satisfaction was consistent with pre-pandemic levels.