• Rev Bras Ter Intensiva · Jan 2021

    Observational Study

    Changes in the management and clinical outcomes of critically ill patients without COVID-19 during the pandemic.

    • Iván Alfredo Huespe, Agustina Marco, Eduardo Prado, BissoIndalecio CarboniIChttp://orcid.org/0000-0002-4834-4676Unidade de Terapia Intensiva, Hospital Italiano de Buenos Aires - Buenos Aires, Argentina., Pablo Coria, Nicolas Gemelli, RománEduardo SanESUnidade de Terapia Intensiva, Hospital Italiano de Buenos Aires - Buenos Aires, Argentina., and HerasMarcos José LasMJLUnidade de Terapia Intensiva, Hospital Italiano de Buenos Aires - Buenos Aires, Argentina..
    • Unidade de Terapia Intensiva, Hospital Italiano de Buenos Aires - Buenos Aires, Argentina.
    • Rev Bras Ter Intensiva. 2021 Jan 1; 33 (1): 68-74.

    ObjectiveTo analyze whether changes in medical care due to the application of COVID-19 protocols affected clinical outcomes in patients without COVID-19 during the pandemic.MethodsThis was a retrospective, observational cohort study carried out in a thirty-eight-bed surgical and medical intensive care unit of a high complexity private hospital. Patients with respiratory failure admitted to the intensive care unit during March and April 2020 and the same months in 2019 were selected. We compared interventions and outcomes of patients without COVID-19 during the pandemic with patients admitted in 2019. The main variables analyzed were intensive care unit respiratory management, number of chest tomography scans and bronchoalveolar lavages, intensive care unit complications, and status at hospital discharge.ResultsIn 2020, a significant reduction in the use of a high-flow nasal cannula was observed: 14 (42%) in 2019 compared to 1 (3%) in 2020. Additionally, in 2020, a significant increase was observed in the number of patients under mechanical ventilation admitted to the intensive care unit from the emergency department, 23 (69%) compared to 11 (31%) in 2019. Nevertheless, the number of patients with mechanical ventilation after 5 days of admission was similar in both years: 24 (69%) in 2019 and 26 (79%) in 2020.ConclusionIntensive care unit protocols based on international recommendations for the COVID-19 pandemic have produced a change in non-COVID-19 patient management. We observed a reduction in the use of a high-flow nasal cannula and an increased number of tracheal intubations in the emergency department. However, no changes in the percentage of intubated patients in the intensive care unit, the number of mechanical ventilation days or the length of stay in intensive care unit.

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