How the COVID-19 pandemic will change the future of critical care.
How the COVID-19 pandemic will change the future of critical care.
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DOI：
10.1007/s00134-021-06352-y
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发表时间：
2021-03
影响因子：
38.9
通讯作者：
Citerio G
中科院分区：
文献类型：
--
作者：
Arabi YM;Azoulay E;Al-Dorzi HM;Phua J;Salluh J;Binnie A;Hodgson C;Angus DC;Cecconi M;Du B;Fowler R;Gomersall CD;Horby P;Juffermans NP;Kesecioglu J;Kleinpell RM;Machado FR;Martin GS;Meyfroidt G;Rhodes A;Rowan K;Timsit JF;Vincent JL;Citerio G
冠状病毒病19(新冠肺炎)给医疗系统带来了前所未有的挑战，其中一些将导致变革性的变化。对于医疗工作者和政策制定者来说，显而易见的是，必须将有效的危重护理激增应对措施嵌套在整体护理提供模式中。新冠肺炎大流行凸显了应急准备的关键要素。这些措施包括拥有国家或区域的个人防护设备、重症监护病房(ICU)设备、消耗品和药品的战略储备，以及有效的供应链和高效的使用协议。ICU还必须准备好容纳激增的患者，ICU人员配备模式应该考虑到需求的波动。应建立、实施和更新先前存在的ICU分诊和临终关怀原则。日常工作流程应该重组，包括与多学科医护人员的远程联系，以及与亲属的频繁沟通。这场大流行还展示了数字化转型的好处和无线监测等远程监测技术的价值。最后，大流行突出了预先存在的流行病学登记和灵活的随机对照平台试验在生成快速、可靠数据方面的价值。新冠肺炎的大流行提醒我们，除了关心的义务外，我们还致力于改善。通过应对今天的这些挑战，我们将能够为未来的患者提供更好的护理。
Coronavirus disease 19 (COVID-19) has posed unprecedented healthcare system challenges, some of which will lead to transformative change. It is obvious to healthcare workers and policymakers alike that an effective critical care surge response must be nested within the overall care delivery model. The COVID-19 pandemic has highlighted key elements of emergency preparedness. These include having national or regional strategic reserves of personal protective equipment, intensive care unit (ICU) devices, consumables and pharmaceuticals, as well as effective supply chains and efficient utilization protocols. ICUs must also be prepared to accommodate surges of patients and ICU staffing models should allow for fluctuations in demand. Pre-existing ICU triage and end-of-life care principles should be established, implemented and updated. Daily workflow processes should be restructured to include remote connection with multidisciplinary healthcare workers and frequent communication with relatives. The pandemic has also demonstrated the benefits of digital transformation and the value of remote monitoring technologies, such as wireless monitoring. Finally, the pandemic has highlighted the value of pre-existing epidemiological registries and agile randomized controlled platform trials in generating fast, reliable data. The COVID-19 pandemic is a reminder that besides our duty to care, we are committed to improve. By meeting these challenges today, we will be able to provide better care to future patients.
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