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Vidal-Cortés P, Martín MC, Díaz E, Bodí M, Igeño JC, Garnacho-Montero J. Impact of one year of pandemic on Spanish Intensive Care Units. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2022; 35:392-400. [PMID: 35678324 PMCID: PMC9333115 DOI: 10.37201/req/025.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/18/2022] [Accepted: 05/23/2022] [Indexed: 12/02/2022]
Abstract
OBJECTIVE To measure the impact of the pandemic in Spanish ICUs. 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.
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Affiliation(s)
- P Vidal-Cortés
- Pablo Vidal-Cortes, Hospital Universitario de Ourense. Ramón Puga 42-54. Ourense, Spain.
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Andaluz-Ojeda D, Vidal-Cortes P, Aparisi Sanz Á, Suberviola B, Del Río Carbajo L, Nogales Martín L, Prol Silva E, Nieto del Olmo J, Barberán J, Cusacovich I. Immunomodulatory therapy for the management of critically ill patients with COVID-19: A narrative review. World J Crit Care Med 2022; 11:269-297. [PMID: 36051937 PMCID: PMC9305685 DOI: 10.5492/wjccm.v11.i4.269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/01/2021] [Accepted: 05/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Understanding the physiological and immunological processes underlying the clinical manifestations of COVID-19 is vital for the identification and rational design of effective therapies. AIM To describe the interaction of SARS-CoV-2 with the immune system and the subsequent contribution of hyperinflammation and abnormal immune responses to disease progression together with a complete narrative review of the different immunoadjuvant treatments used so far in COVID-19 and their indication in severe and life-threatening subsets. METHODS A comprehensive literature search was developed. Authors reviewed the selected manuscripts following the PRISMA recommendations for systematic review and meta-analysis documents and selected the most appropriate. Finally, a recommendation of the use of each treatment was established based on the level of evidence of the articles and documents reviewed. This recommendation was made based on the consensus of all the authors. RESULTS A brief rationale on the SARS-CoV-2 pathogenesis, immune response, and inflammation was developed. The usefulness of 10 different families of treatments related to inflammation and immunopathogenesis of COVID-19 was reviewed and discussed. Finally, based on the level of scientific evidence, a recommendation was established for each of them. CONCLUSION Although several promising therapies exist, only the use of corticosteroids and tocilizumab (or sarilumab in absence of this) have demonstrated evidence enough to recommend its use in critically ill patients with COVID-19. Endotypes including both, clinical and biological characteristics can constitute specific targets for better select certain therapies based on an individualized approach to treatment.
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Affiliation(s)
- David Andaluz-Ojeda
- Department of Critical Care, Hospital Universitario HM Sanchinarro, Hospitales Madrid, Madrid 28050, Spain
| | - Pablo Vidal-Cortes
- Department of Intensive Care, Complejo Hospitalario Universitario de Ourense, Ourense 32005, Spain
| | | | - Borja Suberviola
- Department of Intensive Care, Hospital Universitario Marqués de Valdecilla, Santander 39008, Spain
| | - Lorena Del Río Carbajo
- Department of Intensive Care, Complejo Hospitalario Universitario de Ourense, Ourense 32005, Spain
| | - Leonor Nogales Martín
- Department of Intensive Care, Hospital Clínico Universitario de Valladolid, Valladolid 47005, Spain
| | - Estefanía Prol Silva
- Department of Intensive Care, Complejo Hospitalario Universitario de Ourense, Ourense 32005, Spain
| | - Jorge Nieto del Olmo
- Department of Intensive Care, Complejo Hospitalario Universitario de Ourense, Ourense 32005, Spain
| | - José Barberán
- Department of Internal Medicine, Hospital Universitario HM Montepríncipe, Hospitales Madrid, Boadilla del Monte 28860, Madrid, Spain
| | - Ivan Cusacovich
- Department of Internal Medicine, Hospital Clínico Universitario de Valladolid, Valladolid 47005, Spain
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3
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Pandolfi S, Valdenassi L, Bjørklund G, Chirumbolo S, Lysiuk R, Lenchyk L, Doşa MD, Fazio S. COVID-19 Medical and Pharmacological Management in the European Countries Compared to Italy: An Overview. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4262. [PMID: 35409942 PMCID: PMC8998583 DOI: 10.3390/ijerph19074262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/16/2022] [Accepted: 03/30/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: Italy accounts for more than 150,000 deaths due to the COVID-19 pandemic, leading the top rank in SARS-CoV-2-caused deceases in Europe. A survey on the different ways by which the COVID-19 pandemic emergency was managed in the foreign European countries compared to Italy is the purpose of this paper. (2) Methods: A literature search and various mathematical algorithms to approach a rank scoring scale were used to describe in detail the different approaches used by European countries to manage the COVID-19 pandemic emergency. (3) Results: The study showed that Italy stands at the bottom ranking for COVID-19 management due to its high mortality rate. Possible causes of the observed huge numbers of hospitalization and deaths were (a) the demographic composition of the European country; (b) its decentralized healthcare system organization; (c) the role of correct pharmacology in the early stages before hospitalization. Post-mortem examinations were of paramount importance to elucidate the etiopathogenesis of COVID-19 and to tailor a suitable and proper therapy in the early symptomatic stages of COVID-19, preventing hospitalization. (4) Conclusions: Factors such as the significant impact on elderly people, the public health organization prevalently state-owned and represented mainly by hospitals, and criticism of the home therapy approach toward SARS-CoV-2-infected people, may have concurred in increasing the number of COVID-19 deaths in Italy.
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Affiliation(s)
- Sergio Pandolfi
- High School Master of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (S.P.); (L.V.)
| | - Luigi Valdenassi
- High School Master of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (S.P.); (L.V.)
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), 8610 Mo i Rana, Norway;
| | - Salvatore Chirumbolo
- Council for Nutritional and Environmental Medicine (CONEM), 8610 Mo i Rana, Norway;
| | - Roman Lysiuk
- Department of Pharmacognosy and Botany, Danylo Halytsky Lviv National Medical University, 79010 Lviv, Ukraine;
| | - Larysa Lenchyk
- Department of Standardization Kharkiv, National University of Pharmacy, 61002 Kharkiv, Ukraine;
| | - Monica Daniela Doşa
- Department of Pharmacology, Faculty of Medicine, Ovidius University, 900527 Constanța, Romania;
| | - Serafino Fazio
- Department of Internal Medicine, University of Naples Federico II, 80138 Naples, Italy;
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4
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Vidal-Cortés P, Díaz Santos E, Aguilar Alonso E, Amezaga Menéndez R, Ballesteros MÁ, Bodí MA, Bordejé Laguna ML, Garnacho Montero J, García Sánchez M, López Sánchez M, Martín-Loeches I, Ochagavía Calvo A, Ramírez Galleymore P, Alcántara Carmona S, Andaluz Ojeda D, Badallo Arébalo O, Barrasa González H, Borges Sa M, Castellanos-Ortega Á, Estella Á, Ferrer Roca R, Fraile Gutiérrez V, Fuset Cabanes M, Giménez-Esparza Vich C, González Iglesias C, Hernández-Tejedor A, Igeño Cano JC, Iglesias Posadilla D, Jiménez Rivera JJ, Llanos Jorge C, Llompart-Pou JA, López Camps V, Lorencio Cárdenas C, Marcos Neira P, Martín Delgado MC, Martín-Macho González M, Martín Villén L, Nuvials Casals X, Ortiz Suñer A, Quintana Díaz M, Rascado Sedes P, Recuerda Núñez M, Del Río Carbajo L, Rodríguez Aguirregabiria M, Rodríguez Oviedo A, Seijas Betolaza I, Soriano Cuesta C, Suberviola Cañas B, Vera Ching C, Vidal González Á, Zapata Fenor L, Zaragoza Crespo R. Recommendations for the management of critically ill patients with COVID-19 in Intensive Care Units. Med Intensiva 2022; 46:81-89. [PMID: 34903475 PMCID: PMC8664080 DOI: 10.1016/j.medine.2021.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has led to the admission of a high number of patients to the ICU, generally due to severe respiratory failure. Since the appearance of the first cases of SARS-CoV-2 infection, at the end of 2019, in China, a huge number of treatment recommendations for this entity have been published, not always supported by sufficient scientific evidence or with methodological rigor necessary. Thanks to the efforts of different groups of researchers, we currently have the results of clinical trials, and other types of studies, of higher quality. We consider it necessary to create a document that includes recommendations that collect this evidence regarding the diagnosis and treatment of COVID-19, but also aspects that other guidelines have not considered and that we consider essential in the management of critical patients with COVID-19. For this, a drafting committee has been created, made up of members of the SEMICYUC Working Groups more directly related to different specific aspects of the management of these patients.
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Affiliation(s)
- P Vidal-Cortés
- Medicina Intensiva, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
| | - E Díaz Santos
- Medicina Intensiva, Consorci Corporació Sanitaria Parc Taulí, Sabadell, Spain; Departament de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - E Aguilar Alonso
- Medicina Intensiva, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - R Amezaga Menéndez
- Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - M Á Ballesteros
- Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - M A Bodí
- Medicina Intensiva, Hospital Universitario Joan XXIII, Tarragona, Spain; Universitat Rovira i Virgili, Tarragona, Spain
| | - M L Bordejé Laguna
- Medicina Intensiva, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
| | | | | | - M López Sánchez
- Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - I Martín-Loeches
- Intensive Care Medicine, St James's Hospital, Dublin, Ireland; Trinity College Dublin, School of Medicine, Dublin, Ireland
| | - A Ochagavía Calvo
- Medicina Intensiva, Consorci Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | | | - S Alcántara Carmona
- Medicina Intensiva, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - D Andaluz Ojeda
- Medicina Intensiva, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - O Badallo Arébalo
- Medicina Intensiva, Hospital Universitario de Cruces, Bizkaia, Spain
| | | | - M Borges Sa
- Medicina Intensiva, Hospital Universitario Son Llátzer, Palma de Mallorca, Spain
| | | | - Á Estella
- Medicina Intensiva, Hospital Universitario de Jerez, Jerez, Spain; Departamento de Medicina, INIBICA, Universidad de Cádiz, Cádiz, Spain
| | - R Ferrer Roca
- Medicina Intensiva, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - V Fraile Gutiérrez
- Medicina Intensiva, Hospital Universitario Río Hortega, Valladolid, Spain
| | - M Fuset Cabanes
- Medicina Intensiva, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | | | | | | | - J C Igeño Cano
- Medicina Intensiva, Hospital San Juan de Dios, Córdoba, Spain
| | | | - J J Jiménez Rivera
- Medicina Intensiva, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - C Llanos Jorge
- Medicina Intensiva, Hospital QuirónSalud Tenerife, Tenerife, Spain
| | - J A Llompart-Pou
- Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain
| | - V López Camps
- Medicina Intensiva, Hospital de Sagunto, Sagunto, Spain
| | - C Lorencio Cárdenas
- Medicina Intensiva, Hospital Universitario Doctor Josep Trueta, Girona, Spain
| | - P Marcos Neira
- Medicina Intensiva, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
| | - M C Martín Delgado
- Medicina Intensiva, Hospital Universitario de Torrejón, Torrejón de Ardoz, Spain; Universidad Francisco de Vitoria, Madrid, Spain
| | | | - L Martín Villén
- Medicina Intensiva, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - X Nuvials Casals
- Medicina Intensiva, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - A Ortiz Suñer
- Medicina Intensiva, Hospital Arnau de Vilanova, Valencia, Spain; Facultad de Medicina y Ciencias de la Salud, Universidad Católica de Valencia, Valencia, Spain
| | - M Quintana Díaz
- Medicina Intensiva, Hospital Universitario La Paz, Madrid, Spain; Departamento de Medicina Universidad Autónoma de Madrid, Madrid, Spain
| | - P Rascado Sedes
- Medicina Intensiva, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - M Recuerda Núñez
- Medicina Intensiva, Hospital Universitario Puerto Real, Cádiz, Spain
| | - L Del Río Carbajo
- Medicina Intensiva, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | | | | | - I Seijas Betolaza
- Medicina Intensiva, Hospital Universitario de Cruces, Bizkaia, Spain
| | - C Soriano Cuesta
- Medicina Intensiva, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - B Suberviola Cañas
- Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - C Vera Ching
- Medicina Intensiva, Hospital Universitario Doctor Josep Trueta, Girona, Spain
| | | | - L Zapata Fenor
- Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - R Zaragoza Crespo
- Medicina Intensiva, Hospital Universitario Doctor Peset, Valencia, Spain
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5
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Vidal-Cortés P, Díaz Santos E, Aguilar Alonso E, Amezaga Menéndez R, Ballesteros MÁ, Bodí MA, Bordejé Laguna ML, Garnacho Montero J, García Sánchez M, López Sánchez M, Martín-Loeches I, Ochagavía Calvo A, Ramírez Galleymore P, Alcántara Carmona S, Andaluz Ojeda D, Badallo Arébalo O, Barrasa González H, Borges Sa M, Castellanos-Ortega Á, Estella Á, Ferrer Roca R, Fraile Gutiérrez V, Fuset Cabanes M, Giménez-Esparza Vich C, González Iglesias C, Hernández-Tejedor A, Igeño Cano JC, Iglesias Posadilla D, Jiménez Rivera JJ, Llanos Jorge C, Llompart-Pou JA, López Camps V, Lorencio Cárdenas C, Marcos Neira P, Martín Delgado MC, Martín-Macho González M, Martín Villén L, Nuvials Casals X, Ortiz Suñer A, Quintana Díaz M, Rascado Sedes P, Recuerda Núñez M, Del Río Carbajo L, Rodríguez Aguirregabiria M, Rodríguez Oviedo A, Seijas Betolaza I, Soriano Cuesta C, Suberviola Cañas B, Vera Ching C, Vidal González Á, Zapata Fenor L, Zaragoza Crespo R. [Recommendations for the management of critically ill patients with COVID-19 in Intensive Care Units]. Med Intensiva 2022; 46:81-89. [PMID: 34545260 PMCID: PMC8443328 DOI: 10.1016/j.medin.2021.08.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 11/23/2022]
Abstract
The COVID-19 pandemic has led to the admission of a high number of patients to the ICU, generally due to severe respiratory failure. Since the appearance of the first cases of SARS-CoV-2 infection, at the end of 2019, in China, a huge number of treatment recommendations for this entity have been published, not always supported by sufficient scientific evidence or with methodological rigor necessary. Thanks to the efforts of different groups of researchers, we currently have the results of clinical trials, and other types of studies, of higher quality. We consider it necessary to create a document that includes recommendations that collect this evidence regarding the diagnosis and treatment of COVID-19, but also aspects that other guidelines have not considered and that we consider essential in the management of critical patients with COVID-19. For this, a drafting committee has been created, made up of members of the SEMICYUC Working Groups more directly related to different specific aspects of the management of these patients.
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Affiliation(s)
- P Vidal-Cortés
- Medicina Intensiva, Complexo Hospitalario Universitario de Ourense, Ourense, España
| | - E Díaz Santos
- Medicina Intensiva, Consorci Corporació Sanitaria Parc Taulí, Sabadell, España
- Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, España
| | - E Aguilar Alonso
- Medicina Intensiva, Hospital Universitario Reina Sofía, Córdoba, España
| | - R Amezaga Menéndez
- Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, España
| | - M Á Ballesteros
- Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España
- Instituto de Investigación Valdecilla (IDIVAL), Santander, España
| | - M A Bodí
- Medicina Intensiva, Hospital Universitario Joan XXIII, Tarragona, España
- Universitat Rovira i Virgili, Tarragona, España
| | - M L Bordejé Laguna
- Medicina Intensiva, Hospital Universitario Germans Trias i Pujol, Badalona, España
| | | | | | - M López Sánchez
- Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - I Martín-Loeches
- Intensive Care Medicine, St Jameśs Hospital, Dublín, Irlanda
- Trinity College Dublin, School of Medicine, Dublín, Irlanda
| | - A Ochagavía Calvo
- Medicina Intensiva, Consorci Corporació Sanitaria Parc Taulí, Sabadell, España
| | | | - S Alcántara Carmona
- Medicina Intensiva, Hospital Universitario Puerta de Hierro, Majadahonda, España
| | - D Andaluz Ojeda
- Medicina Intensiva, Hospital Universitario HM Sanchinarro, Madrid, España
| | - O Badallo Arébalo
- Medicina Intensiva, Hospital Universitario de Cruces, Bizkaia, España
| | | | - M Borges Sa
- Medicina Intensiva, Hospital Universitario Son Llàtzer, Palma de Mallorca, España
| | | | - Á Estella
- Medicina Intensiva, Hospital Universitario de Jerez, Jerez, España
- Departamento de Medicina, INIBICA, Universidad de Cádiz, Cádiz, España
| | - R Ferrer Roca
- Medicina Intensiva, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - V Fraile Gutiérrez
- Medicina Intensiva, Hospital Universitario Río Hortega, Valladolid, España
| | - M Fuset Cabanes
- Medicina Intensiva, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | | | | | | | - J C Igeño Cano
- Medicina Intensiva, Hospital San Juan de Dios, Córdoba, España
| | | | - J J Jiménez Rivera
- Medicina Intensiva, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España
| | - C Llanos Jorge
- Medicina Intensiva, Hospital QuirónSalud, Tenerife, España
| | - J A Llompart-Pou
- Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, España
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, España
| | - V López Camps
- Medicina Intensiva, Hospital de Sagunto, Sagunto, España
| | - C Lorencio Cárdenas
- Medicina Intensiva, Hospital Universitario Doctor Josep Trueta, Girona, España
| | - P Marcos Neira
- Medicina Intensiva, Hospital Universitario Germans Trias i Pujol, Badalona, España
| | - M C Martín Delgado
- Medicina Intensiva, Hospital Universitario de Torrejón, Torrejón de Ardoz, España
- Universidad Francisco de Vitoria, Madrid, España
| | | | - L Martín Villén
- Medicina Intensiva, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - X Nuvials Casals
- Medicina Intensiva, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - A Ortiz Suñer
- Medicina Intensiva, Hospital Arnau de Vilanova, Valencia, España
- Facultad de Medicina y Ciencias de la Salud, Universidad Católica de Valencia, Valencia, España
| | - M Quintana Díaz
- Medicina Intensiva, Hospital Universitario La Paz, Madrid, España
- Departamento de Medicina Universidad Autónoma de Madrid, Madrid, España
| | - P Rascado Sedes
- Medicina Intensiva, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - M Recuerda Núñez
- Medicina Intensiva, Hospital Universitario Puerto Real, Cádiz, España
| | - L Del Río Carbajo
- Medicina Intensiva, Complexo Hospitalario Universitario de Ourense, Ourense, España
| | | | - A Rodríguez Oviedo
- Medicina Intensiva, Hospital Universitario Joan XXIII, Tarragona, España
| | - I Seijas Betolaza
- Medicina Intensiva, Hospital Universitario de Cruces, Bizkaia, España
| | - C Soriano Cuesta
- Medicina Intensiva, Hospital Universitario Ramón y Cajal, Madrid, España
| | - B Suberviola Cañas
- Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - C Vera Ching
- Medicina Intensiva, Hospital Universitario Doctor Josep Trueta, Girona, España
| | | | - L Zapata Fenor
- Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - R Zaragoza Crespo
- Medicina Intensiva, Hospital Universitario Doctor Peset, Valencia, España
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6
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Estella Á, Vidal-Cortés P, Rodríguez A, Andaluz Ojeda D, Martín-Loeches I, Díaz E, Suberviola B, Gracia Arnillas MP, Catalán González M, Álvarez-Lerma F, Ramírez P, Nuvials X, Borges M, Zaragoza R. Management of infectious complications associated with coronavirus infection in severe patients admitted to ICU. Med Intensiva 2021; 45:485-500. [PMID: 34475008 PMCID: PMC8382590 DOI: 10.1016/j.medine.2021.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/17/2021] [Indexed: 12/29/2022]
Abstract
Infections have become one of the main complications of patients with severe SARS-CoV-2 pneumonia admitted in ICU. Poor immune status, frequent development of organic failure requiring invasive supportive treatments, and prolonged ICU length of stay in saturated structural areas of patients are risk factors for infection development. The Working Group on Infectious Diseases and Sepsis GTEIS of the Spanish Society of Intensive Medicine and Coronary Units SEMICYUC emphasizes the importance of infection prevention measures related to health care, the detection and early treatment of major infections in the patient with SARS-CoV-2 infections. Bacterial co-infection, respiratory infections related to mechanical ventilation, catheter-related bacteremia, device-associated urinary tract infection and opportunistic infections are review in the document.
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Affiliation(s)
- Á Estella
- Servicio de Medicina Intensiva, Hospital Universitario de Jerez, Departamento de Medicina, Facultad de Medicina de Cádiz, Jerez de la Frontera, Cádiz, Spain.
| | - P Vidal-Cortés
- Servicio de Medicina Intensiva, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | - A Rodríguez
- Servicio de Medicina Intensiva, Hospital Universitario Joan XXIII de Tarragona, Tarragona, Spain
| | - D Andaluz Ojeda
- Servicio de Medicina Intensiva, Hospital Universitario de Sanchinarro de Madrid, Madrid, Spain
| | - I Martín-Loeches
- PhD JFICMI Consultant in Intensive Care Medicine, CLOD Dublin Midlands Group, St James's University Hospital, Trinity Centre for Health Sciences, HRB-Welcome Trust St James's Hospital, Dublin, EIRE, Universidad de Barcelona, Barcelona, Spain
| | - E Díaz
- Servicio de Medicina Intensiva, Hospital Parc Tauli, Sabadell, Spain
| | - B Suberviola
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - M P Gracia Arnillas
- Servicio de Medicina Intensiva, Hospital Universitario del Mar, Barcelona, Spain
| | - M Catalán González
- Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - F Álvarez-Lerma
- Servicio de Medicina Intensiva, Parc de Salut Mar, Hospital del Mar, Barcelona, Spain
| | - P Ramírez
- Servicio de Medicina Intensiva, Hospital La Fe de Valencia, Valencia, Spain
| | - X Nuvials
- Servicio de Medicina Intensiva, Hospital Vall d'Hebrón, Barcelona, Spain
| | - M Borges
- Unidad Multidisciplinar de Sepsis, Servicio de Medicina Intensiva, Hospital Universitario Son Llatzer, IDISBA, Enfermedades Infecciosas UIB, Palma de Mallorca, Área de Sepsis e Infecciosas, Federación Ibérica y Panamericana de Medicina Intensiva (FEPIMCTI), Palma de Mallorca, Spain
| | - R Zaragoza
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, Spain
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7
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Estella Á, Vidal-Cortés P, Rodríguez A, Andaluz Ojeda D, Martín-Loeches I, Díaz E, Suberviola B, Gracia Arnillas MP, Catalán González M, Álvarez-Lerma F, Ramírez P, Nuvials X, Borges M, Zaragoza R. [Management of infectious complications associated with coronavirus infection in severe patients admitted to ICU]. Med Intensiva 2021; 45:485-500. [PMID: 33994616 PMCID: PMC8086823 DOI: 10.1016/j.medin.2021.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/13/2021] [Accepted: 04/17/2021] [Indexed: 12/29/2022]
Abstract
Infections have become one of the main complications of patients with severe SARS-CoV-2 pneumonia admitted in ICU. Poor immune status, frequent development of organic failure requiring invasive supportive treatments, and prolonged ICU length of stay in saturated structural areas of patients are risk factors for infection development. The Working Group on Infectious Diseases and Sepsis GTEIS of the Spanish Society of Intensive Medicine and Coronary Units SEMICYUC emphasizes the importance of infection prevention measures related to health care, the detection and early treatment of major infections in the patient with SARS-CoV-2 infections. Bacterial co-infection, respiratory infections related to mechanical ventilation, catheter-related bacteremia, device-associated urinary tract infection and opportunistic infections are review in the document.
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Affiliation(s)
- Á Estella
- Servicio de Medicina Intensiva, Hospital Universitario de Jerez, Departamento de Medicina, Facultad de Medicina de Cádiz, Jerez de la Frontera, Cádiz, España
| | - P Vidal-Cortés
- Servicio de Medicina Intensiva, Complexo Hospitalario Universitario de Ourense, Ourense, España
| | - A Rodríguez
- Servicio de Medicina Intensiva, Hospital Universitario Joan XXIII de Tarragona, Tarragona, España
| | - D Andaluz Ojeda
- Servicio de Medicina Intensiva, Hospital Universitario de Sanchinarro de Madrid, Madrid, España
| | - I Martín-Loeches
- PhD JFICMI Consultant in Intensive Care Medicine, CLOD Dublin Midlands group, St James's University Hospital, Trinity Centre for Health Sciences, HRB-Welcome Trust St James's Hospital, Dublín, EIRE, Universidad de Barcelona, Barcelona, España
| | - E Díaz
- Servicio de Medicina Intensiva, Hospital Parc Tauli, Sabadell, España
| | - B Suberviola
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla. Santander, España
| | - M P Gracia Arnillas
- Servicio de Medicina Intensiva, Hospital Universitario del Mar, Barcelona, España
| | - M Catalán González
- Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España
| | - F Álvarez-Lerma
- Servicio de Medicina Intensiva, Parc de Salut Mar, Hospital del Mar, Barcelona, España
| | - P Ramírez
- Servicio de Medicina Intensiva, Hospital La Fe de Valencia, Valencia, España
| | - X Nuvials
- Servicio de Medicina Intensiva, Hospital Vall d'Hebrón, Barcelona, España
| | - M Borges
- Unidad Multidisciplinar de Sepsis, Servicio de Medicina Intensiva, Hospital Universitario Son Llatzer, IDISBA, Enfermedades Infecciosas UIB, Palma de Mallorca, Área de Sepsis e Infecciosas, Federación Ibérica y Panamericana de Medicina Intensiva (FEPIMCTI), Palma de Mallorca, España
| | - R Zaragoza
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España
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