Planning for the assistance of critically ill patients in a Pandemic Situation: The experience of Vall d'Hebron University Hospital. 2020

Ricard Ferrer, and Marcelino Báguena, and Joan Balcells, and Jordi Bañeras, and Alfons Biarnes, and Miriam de Nadal, and Rosa María Gracia, and Jesús Martinez, and Xavier Nuvials, and Jordi Riera, and Oriol Roca, and Juan Carlos Ruiz-Rodriguez
Servicio de Medicina Intensiva. Hospital Universitario Vall d'Hebron. Sepsis Organ Dysfunction and Resuscitation (SODIR) Research group. Vall d'Hebron Institut de Recerca (VHIR). Universidad Autónoma de Barcelona (UAB), Barcelona, España. Electronic address: r.ferrer@vhebron.net.

BACKGROUND In the context of community transmission of the virus, the impact of the pandemic on health-care systems, mainly on intensive care units (ICU), was expected to be devastating. Vall d́Hebron University Hospital (HUVH) implemented an unprecedented critical patient-care planning and management of resources. METHODS We describe a cohort of critically ill patients during the first two months of the pandemic (from March 3, 2020, to May 2, 2020) in HUVH, Barcelona. In this manuscript, we report our previsions, strategies implemented, and the outcomes obtained. RESULTS Three-thousand and thirty-three patients were admitted to the HUVH Critical Care Units. Throughout the study period, the proportion of patients on IMV or IMV and ECMO remained above 78%. Most patients were men (65%); the most common age group was 60-70 years. Twenty-three patients received ECMO, and eighteen were cannulated at another center and transferred to HUVH. At the end of the study, fourteen patients were successfully decannulated, three patients died, and the rest of the patients were still on ECMO. Eight pregnant women have been treated in the ICU, with a survival rate of 100%. The ICU mortality of patients younger than 60 years was 3.2%. The mean ICU stay of both survivors and nonsurvivors was 14 days. CONCLUSIONS The adequate preparation for resource expansion for critically ill patients care, main challenges, and overall positive results can serve as a precedent for similar future scenarios.

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