https://doi.org/10.4081/monaldi.2022.2358
Respiratory Intensive Care Unit management and efficacy during the COVID-19 outbreak in Naples, Italy
Submitted: June 22, 2022
Accepted: August 24, 2022
Published: September 5, 2022
Accepted: August 24, 2022
Abstract Views: 1058
PDF: 358
Supplementary: 153
Supplementary: 153
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The World Health Organization declared the Coronavirus Diseases 2019 (COVID-19) outbreak a global pandemic on March 11, 2020. COVID-19 had an impact on over 500 million people worldwide. According to the American Thoracic Society criteria, the respiratory spectrum of this disease ranges from mild illness to severe pneumonia, with the latter occurring in a not insignificant 15% of patients. A rapid increase in the incidence of COVID-19 pneumonia cases has been observed all over the world, resulting in a saturation of the Intensive Care Unit's capacity (ICUs). Because of this impressive outbreak, the ICU beds and invasive mechanical ventilators reached their capacity. Non-invasive supportive care has become an important option for keeping respiratory conditions under control. As a result, proper healthcare resource management was required to ensure adequate patient care. Respiratory Intensive Care Units (RICUs) have become a useful resource for managing complex patients due to a shortage of ICU capacity. This highlighted the importance of RICUs, where patients with moderate to severe respiratory failure can be treated with non-invasive respiratory support rather than being admitted to the ICU. The clinical outcomes and baseline characteristics of patients admitted to the RICU of Cotugno Hospital, a tertiary referral center in Naples (Italy), from January 2021 to October 2021 are described in this report.
Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:72733.
DOI: https://doi.org/10.1056/NEJMoa2001017
Guan W, Ni Z, Hu Yu, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-20.
DOI: https://doi.org/10.1056/NEJMoa2002032
Emanuel EJ, Persad G, Upshur R, et al. Fair allocation of scarce medical resources in the time of Covid-19. N Engl J Med 2020; 382:2049–55.
DOI: https://doi.org/10.1056/NEJMsb2005114
Ramachandran P, Swamy L, Kaul V, Agrawal A. A national strategy for ventilator and ICU resource allocation during the COVID-19 pandemic. Chest 2020;158:887–9.
DOI: https://doi.org/10.1016/j.chest.2020.04.050
Weiss P, Murdoch DR. Clinical course and mortality risk of severe COVID-19. Lancet 2020;395:1014–5.
DOI: https://doi.org/10.1016/S0140-6736(20)30633-4
Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA 2020;323:1574-81.
DOI: https://doi.org/10.1001/jama.2020.5394
Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323:1061-9.
DOI: https://doi.org/10.1001/jama.2020.1585
Plate JDJ, Leenen LPH, Houwert M, Hietbrink F. Utilisation of intermediate care units: a systematic review. Crit Care Res Pract 2017;2017:8038460.
Patel BK, Wolfe KS, Pohlman AS, Hall JB, Kress JP. Effect of noninvasive ventilation delivered by helmet vs face mask on the rate of endotracheal intubation in patients with acute respiratory distress syndrome: A randomized clinical trial. JAMA 2016;315:2435–41.
DOI: https://doi.org/10.1001/jama.2016.6338
Frat JP, Thille AW, Mercat A, et al. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med 2015;372:2185–96.
DOI: https://doi.org/10.1056/NEJMoa1503326
Pierucci P, Ambrosino N, Di Lecce V, et al. Prolonged active prone positioning in spontaneously breathing non-intubated patients with COVID-19-associated hypoxemic Acute respiratory failure with PaO2/FiO2 >150. Front Med (Lausanne) 2021;8:626321.
DOI: https://doi.org/10.3389/fmed.2021.626321
Longhini F, Bruni A, Garofalo E, et al. Helmet continuous positive airway pressure and prone positioning: A proposal for an early management of COVID-19 patients. Pulmonology 2020;26:186-91.
DOI: https://doi.org/10.1016/j.pulmoe.2020.04.014
Ehrmann S, Li J, Ibarra-Estrada M, et al. Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: a randomised, controlled, multinational, open-label meta-trial. Lancet Respir Med 2021;9:1387-95.
DOI: https://doi.org/10.1016/S2213-2600(21)00356-8
Docherty AB, Harrison EM, Green CA, et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ 2020;369:m1985.
DOI: https://doi.org/10.1136/bmj.m1985
Prin M, Wunsch H. The role of stepdown beds in hospital care. Am J Respir Crit Care Med 2014;190:1210–6.
DOI: https://doi.org/10.1164/rccm.201406-1117PP
Plate JDJ, Leenen LPH, Houwert M, Hietbrink F. Utilisation of intermediate care units: a systematic review. Crit Care Res Pract 2017;2017:8038460.
DOI: https://doi.org/10.1155/2017/8038460
Capuzzo M, Volta CA, Tassinati T, et al. Hospital mortality of adults admitted to intensive care units in hospitals with and without intermediate care units: a multicentre European cohort study. Crit Care 2014;18:551.
DOI: https://doi.org/10.1186/s13054-014-0551-8
Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology 2020;295:202-7.
DOI: https://doi.org/10.1148/radiol.2020200230
Franco C, Facciolongo N, Tonelli R, Dongilli R, Vianello A, Pisani L, et al. Feasibility and clinical impact of out-of-ICU non-invasive respiratory support in patients with COVID-19 related pneumonia. Eur Respir J 2020;56:2002130.
DOI: https://doi.org/10.1183/13993003.02130-2020
Higgs A, McGrath BA, Goddard C, et al. Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth 2018;120:323-52.
DOI: https://doi.org/10.1016/j.bja.2017.10.021
Antonelli M, Conti G, Esquinas A, et al. A multiple-center survey on the use in clinical practice of noninvasive ventilation as a first-line intervention for acute respiratory distress syndrome. Crit Care Med 2007;35:18-25.
DOI: https://doi.org/10.1097/01.CCM.0000251821.44259.F3
Polistina GE, Lanza M, Di Somma C, et al. A rare evolution to pneumopericardium in patient with COVID-19 pneumonia treated with high flow nasal cannula. Medicina (Kaunas) 2021;57:1122.
DOI: https://doi.org/10.3390/medicina57101122
Simioli F, Annunziata A, Langella G, et al. Clinical outcomes of high-flow nasal cannula in COVID-19 associated postextubation respiratory failure. A single-centre case series. Anaesthesiol Intensive Ther 2020;52:373-6.
DOI: https://doi.org/10.5114/ait.2020.101007
Imitazione P, Polistina GE, Annunziata A, et al. Acute respiratory failure in COVID-19 pneumoniae: The best interface for an optimal management. A South Italian experience. Turk Thorac J 2020;21:289-90.
DOI: https://doi.org/10.5152/TurkThoracJ.2020.20071
Primmaz S, Le Terrier C, Suh N, et al. Preparedness and reorganization of care for coronavirus disease 2019 patients in a Swiss ICU: characteristics and outcomes of 129 patients. Crit Care Explor 2020;2:e0173.
DOI: https://doi.org/10.1097/CCE.0000000000000173
McEnery T, Gough C, Costello RW. COVID-19: Respiratory support outside the intensive care unit. Lancet Respir Med 2020;8:538-9.
DOI: https://doi.org/10.1016/S2213-2600(20)30176-4
How to Cite
Polistina, Giorgio E., Camilla Di Somma, Martina Flora, Alberto E. Maraolo, Novella Carannante, Gerardo Langella, Angela I. Mirizzi, Anna Annunziata, and Giuseppe Fiorentino. 2022. “Respiratory Intensive Care Unit Management and Efficacy During the COVID-19 Outbreak in Naples, Italy”. Monaldi Archives for Chest Disease 93 (2). https://doi.org/10.4081/monaldi.2022.2358.
Copyright (c) 2022 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Thomas Galasso, Lorenzo Corbetta, Laura Mancino, Lucio Michieletto, Loris Ceron, Statistical approach to mediastinal staging in NSCLC with M.E.S.S.i.a. software , Monaldi Archives for Chest Disease: Vol. 89 No. 3 (2019)
- Lucrezia De Michele, Paola Pierucci, Guido Giovannetti, Arnaldo Scardapane, Carlo D'agostino, Giovanna Elisiana Carpagnano, Authors’ response to the Letter to the Editor regarding: Post severe COVID-19 infection lung damages study. The experience of early three months multidisciplinary follow-up , Monaldi Archives for Chest Disease: Vol. 92 No. 4 (2022)
You may also start an advanced similarity search for this article.
