Patient care in rapid-expansion intensive care units during the COVID-19 pandemic crisis

TitlePatient care in rapid-expansion intensive care units during the COVID-19 pandemic crisis
Publication TypeJournal Article
Year of Publication2022
AuthorsBasem JI, Roth AF, White RS, Tangel VE, Jiang SY, Choi JM, Hoffman KL, Schenck EJ, Turnbull ZA, Pryor KO, Ivascu NS, Memtsoudis SG, Goldstein PA
JournalBMC Anesthesiol
Volume22
Issue1
Pagination209
Date Published07/07/2022
ISSN1471-2253
KeywordsCOVID-19, Critical Care, Epidemiology, ICU outcomes, Intensive care
Abstract

BACKGROUND: The coronavirus-2019 (COVID-19) pandemic highlighted the unfortunate reality that many hospitals have insufficient intensive care unit (ICU) capacity to meet massive, unanticipated increases in demand. To drastically increase ICU capacity, NewYork-Presbyterian/Weill Cornell Medical Center modified its existing operating rooms and post-anaesthesia care units during the initial expansion phase to accommodate the surge of critically ill patients.

METHODS: This retrospective chart review examined patient care in non-standard Expansion ICUs as compared to standard ICUs. We compared clinical data between the two settings to determine whether the expeditious development and deployment of critical care resources during an evolving medical crisis could provide appropriate care.

RESULTS: Sixty-six patients were admitted to Expansion ICUs from March 1st to April 30th, 2020 and 343 were admitted to standard ICUs. Most patients were male (70%), White (30%), 45-64 years old (35%), non-smokers (73%), had hypertension (58%), and were hospitalized for a median of 40 days. For patients that died, there was no difference in treatment management, but the Expansion cohort had a higher median ICU length of stay (q = 0.037) and ventilatory length (q = 0.015). The cohorts had similar rates of discharge to home, but the Expansion ICU cohort had higher rates of discharge to a rehabilitation facility and overall lower mortality.

CONCLUSIONS: We found no significantly worse outcomes for the Expansion ICU cohort compared to the standard ICU cohort at our institution during the COVID-19 pandemic, which demonstrates the feasibility of providing safe and effective care for patients in an Expansion ICU.

DOI10.1186/s12871-022-01752-z
PubMed ID35794523
PubMed Central IDPMC9261025

Center for Perioperative Outcomes
NewYork-Presbyterian Hospital 
Weill Cornell Medical Center
428 East 72nd Street, Suite 800A
New York, NY 10021
cpo@med.cornell.edu