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Pacientes críticos COVID-19 atendidos por anestesiólogos en el Noroeste de España: estudio multicéntrico,prospectivo, observacional
Authors:M Taboada  P Rama  R Pita-Romero  E Moreno  S Leal  M Varela  M Cid  V Caruezo  S Alvarado de la Torre  M Corujeira  A Sarmiento  B Domínguez  P Diaz  L Cánovas  M López Sánchez  E Vilas  A Rodríguez  L Freire  PG Atanassoff
Institution:1. Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, España;2. Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario A Coruña, La Coruña, España;3. Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario de Vigo, Vigo, España;4. Servicio de Anestesiología y Reanimación, Hospital Arquitecto Marcide de Ferrol, Ferrol, España;5. Servicio de Anestesiología y Reanimación, Hospital POVISA de Vigo, Vigo, España;6. Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario Pontevedra, Pontevedra, España;7. Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario Ourense, Orense, España;8. Servicio de Anestesiología, Universidad de Basilea, Basilea, Suiza
Abstract:Background and objectivesThere are limited information on outcome, complications and treatments of critically ill COVID-19 patients requiring admission to an intensive care unit (ICU). The aim of this study is to describe the clinical ICU course, treatments used, complications and outcomes, of critically ill COVID-19 patients admitted in seven ICU in Galicia region during the 2020 March-April pandemic peak.MethodsBetween March 21 and April 19, 2020, we evaluated critically ill COVID-19 patients admitted to the ICU of Anesthesia of seven hospitals in Galicia, northwestern Spain. Outcome, complications, and treatments were monitored until May 6, 2020, the final date of follow-up.ResultsA total of 97 critically ill COVID-19 patients were included. During ICU stay, mechanical ventilation became necessary in 80 (82.5%) patients, and tracheostomy in 22 (22.7%) patients. Prone position was used frequently in both intubated (67.5%) and awake (27.8%) patients. Medications consisted of antivirals agents (92.7%), corticosteroids (93.8%), tocilizumab (57.7%), and intermediate or high doses of anticoagulants (83.5%). The most frequent complications were ICU-acquired infection (52.6%), thrombosis events (16.5%), and reintubation (9.3%). After a median follow-up of 42 (34-45) days, 15 patients (15.5%) deceased, 73 patients (75.2%) had been discharged from ICU, and nine patients (9.3%) were still in the ICU.ConclusionsA high proportion of our critically ill COVID-19 patients required mechanical ventilation, prone positioning, antiviral medication, corticosteroids, and anticoagulants. ICU complications were frequent, mainly infections and thrombotic events. We had a relatively low mortality of 15,5%.
Keywords:COVID-19  SARS-CoV-2  Critically ill patients  Acute respiratory distress syndrome (ARDS)  Prone positioning  Corticosteroids
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