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Surge capacity of intensive care units in case of acute increase in demand caused by COVID-19 in Australia.

在澳大利亚新型冠状病毒肺炎导致需求急剧增加的情况下,重症监护病房的激增能力。

  • 影响因子:1.23
  • DOI:10.5694/mja2.50596
  • 作者列表:"Litton E","Bucci T","Chavan S","Ho YY","Holley A","Howard G","Huckson S","Kwong P","Millar J","Nguyen N","Secombe P","Ziegenfuss M","Pilcher D
  • 发表时间:2020-06-01
Abstract

OBJECTIVES:To assess the capacity of intensive care units (ICUs) in Australia to respond to the expected increase in demand associated with COVID-19. DESIGN:Analysis of Australian and New Zealand Intensive Care Society (ANZICS) registry data, supplemented by an ICU surge capability survey and veterinary facilities survey (both March 2020). SETTINGS:All Australian ICUs and veterinary facilities. MAIN OUTCOME MEASURES:Baseline numbers of ICU beds, ventilators, dialysis machines, extracorporeal membrane oxygenation machines, intravenous infusion pumps, and staff (senior medical staff, registered nurses); incremental capability to increase capacity (surge) by increasing ICU bed numbers; ventilator-to-bed ratios; number of ventilators in veterinary facilities. RESULTS:The 191 ICUs in Australia provide 2378 intensive care beds during baseline activity (9.3 ICU beds per 100 000 population). Of the 175 ICUs that responded to the surge survey (with 2228 intensive care beds), a maximal surge would add an additional 4258 intensive care beds (191% increase) and 2631 invasive ventilators (120% increase). This surge would require additional staffing of as many as 4092 senior doctors (245% increase over baseline) and 42 720 registered ICU nurses (269% increase over baseline). An additional 188 ventilators are available in veterinary facilities, including 179 human model ventilators. CONCLUSIONS:The directors of Australian ICUs report that intensive care bed capacity could be near tripled in response to the expected increase in demand caused by COVID-19. But maximal surge in bed numbers could be hampered by a shortfall in invasive ventilators and would also require a large increase in clinician and nursing staff numbers.

摘要

目的: 评估澳大利亚重症监护病房 (icu) 应对与新型冠状病毒肺炎相关的预期需求增长的能力。 设计: 分析澳大利亚和新西兰重症监护协会 (ANZICS) 登记数据,并辅以ICU激增能力调查和兽医设施调查 (均为 2020 年 3 月)。 设置: 所有澳大利亚icu和兽医设施。 主要观察指标: ICU病床、呼吸机、透析机、体外膜肺氧合机、静脉输液泵和工作人员 (高级医务人员、注册护士) 的基线数量; 通过增加ICU床数量增加容量 (浪涌) 的增量能力; 呼吸机与床的比率; 兽医设施中的呼吸机数量。 结果: 澳大利亚的 191 ICU在基线活动期间提供了 2378 张重症监护床位 (每 9.3 000 人口 100 张ICU床位)。在对激增调查做出回应的 175 个icu中 (拥有 2228 张重症监护病床),最大的激增将增加 4258 张重症监护病床 (增加 191% 张) 2631 台有创呼吸机 (增加 120%)。这一激增将需要增加多达 4092 名高级医生 (比基线增加 245%) 和 42 720 名注册ICU护士 (比基线增加 269%) 的人员配置。兽医设施还提供另外 188 台呼吸机,包括 179 台人体模型呼吸机。 结论: 澳大利亚icu的主管报告说,重症监护床的容量可能接近三倍,以应对新型冠状病毒肺炎导致的需求预期增加。但是床位数量的最大激增可能会受到有创呼吸机短缺的阻碍,也需要大量增加临床医生和护理人员的数量。

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翻译标题与摘要 下载文献
影响因子:2.48
发表时间:2020-04-01
来源期刊:Infection
DOI:10.1007/s15010-020-01401-y
作者列表:["Cheng ZJ","Shan J"]

METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.

呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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