• Annals of intensive care · Oct 2020

    Use of critical care resources during the first 2 weeks (February 24-March 8, 2020) of the Covid-19 outbreak in Italy.

    • Tommaso Tonetti, Giacomo Grasselli, Alberto Zanella, Giacinto Pizzilli, Roberto Fumagalli, Simone Piva, Luca Lorini, Giorgio Iotti, Giuseppe Foti, Sergio Colombo, Luigi Vivona, Sandra Rossi, Massimo Girardis, Vanni Agnoletti, Anselmo Campagna, Giovanni Gordini, Paolo Navalesi, Annalisa Boscolo, Alessandro Graziano, Ilaria Valeri, Andrea Vianello, Danilo Cereda, Claudia Filippini, Maurizio Cecconi, Franco Locatelli, Michele Bartoletti, Maddalena Giannella, Pierluigi Viale, Massimo Antonelli, Stefano Nava, Antonio Pesenti, V Marco Ranieri, and COVID-19 Northern Italian ICU Network.
    • Alma Mater Studiorum, Dipartimento Di Scienze Mediche E Chirurgiche, Anesthesia and Intensive Care Medicine, Università Di Bologna, Policlinico Di Sant'Orsola, Via Massarenti, 9 40138, Bologna, Italy. tommaso.tonetti@unibo.it.
    • Ann Intensive Care. 2020 Oct 12; 10 (1): 133.

    BackgroundA Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary.ResultsIn order to evaluate the impact of Covid-19 on the ICU capacity to manage critically ill patients, we performed a retrospective analysis of the first 2 weeks of the outbreak (February 24-March 8). Data were collected from regional registries and from a case report form sent to participating sites. ICU beds increased from 1545 to 1989 (28.7%), and patients receiving respiratory support outside the ICU increased from 4 (0.6%) to 260 (37.0%). Patients receiving respiratory support outside the ICU were significantly older [65 vs. 77 years], had more cerebrovascular (5.8 vs. 13.1%) and renal (5.3 vs. 10.0%) comorbidities and less obesity (31.4 vs. 15.5%) than patients admitted to the ICU. PaO2/FiO2 ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO2 and base excess were lower [34 vs. 42 mmHg; 0.60 vs. 1.30] in patients receiving respiratory support outside the ICU than in patients admitted to the ICU, respectively.ConclusionsIncrease in ICU beds and use of out-of-ICU respiratory support allowed effective management of the first 14 days of the Covid-19 outbreak, avoiding resource rationing.

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