e7f3860e7e35db1e48b27eb883da488b pmc_9141338.pdf 656202518b7741f789cf1313a1d2bfeed49a8df4 pmc_9141338.pdf 8feba2c83d090b5a23e45584e77306d01aab962693f33653d93d86391b545aa1 pmc_9141338.pdf Title: Effectiveness of Intermediate Respiratory Care Units as an Alternative to Intensive Care Units during the COVID-19 Pandemic in Catalonia Subject: AbstractObjectives: During the COVID-19 pandemic, the risk of collapse for the health system created great difficulties. We will demonstrate that intermediate respiratory care units (IRCU) provide adequate management of patients with non-invasive respiratory support, which is particularly important for patients with SARS-CoV-2 pneumonia. Methods: A prospective observational study of patients with COVID-19 admitted to the ICU of a tertiary hospital. Sociodemographic data, comorbidities, pharmacological, respiratory support, laboratory and blood gas variables were collected. The overall cost of the unit was subsequently analyzed. Results: 991 patients were admitted, 56 to the IRCU (from a of 81 admitted to the critical care unit). Mean age was 65 years (SD 12.8), Barthel index 75 (SD 8.3), Charlson comorbidity index 3.1 (SD 2.2), HTN 27%, COPD 89% and obesity 24%. A significant relationship (p < 0.05) with higher mortality was noted for the following parameters: fever greater than or equal to 39 C [OR 5.6; 95% CI (1.2–2.7); p = 0.020], protocolized pharmacological treatment [OR 0.3; 95% CI (0.1–0.9); p = 0.023] and IOI [OR 3.7; 95% CI (1.1–12.3); p = 0.025]. NIMV had less of a negative impact [OR 1.8; 95% CI (0.4–8.4); p = 0.423] than IOI. The total cost of the IRCU amounted to €66,233. The cost per day of stay in the IRCU was €164 per patient. The total cost avoided was €214,865. Conclusions: The pandemic has highlighted the importance of IRCUs in facilitating the management of a high patient volume. The treatment carried out in IRCUs is effective and efficient, reducing both admissions to and stays in the ICU. Keywords: respiratory care; COVID; ICU; cost-effectiveness Author: Marina Galdeano Lozano, Julio César Alfaro Álvarez, Núria Parra Macías, Rosario Salas Campos, Sarah Heili Frades, Josep Maria Montserrat, Antoni Rosell Gratacós, Jorge Abad Capa, Olga Parra Ordaz and Francesc López Seguí Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue May 17 04:38:17 2022 CEST ModDate: Tue May 17 04:41:14 2022 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1170373 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- LEQYSX+VnURWPalladioL Type 1 Custom yes yes no 10 0 RAVSOH+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 QMCXBF+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 SKUFCJ+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 AHSHLD+CMSY10 Type 1 Builtin yes yes no 28 0 UJUUJI+PazoMath Type 1 Builtin yes yes no 32 0 NHJDXS+VnURWPalladioL-Bold Type 1 Custom yes yes no 36 0 LWQXII+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 54 0 IRWHZX+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 57 0 KAEFHI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 92 0 KAEFHK+PalatinoLinotype TrueType WinAnsi yes yes no 95 0 KAEFIL+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 98 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 105 0 KAEFIL+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 121 0 KAEFHI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 124 0 KAEFHK+PalatinoLinotype TrueType WinAnsi yes yes no 127 0 PZIJIN+PazoMath-Bold Type 1 Builtin yes yes no 144 0 KAEFHI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 157 0 KAEFHK+PalatinoLinotype TrueType WinAnsi yes yes no 160 0 KAEFIL+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 163 0 KAEFHI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 181 0 KAEFHK+PalatinoLinotype TrueType WinAnsi yes yes no 184 0 KAEFIL+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 187 0 KAEFHI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 204 0 KAEFHK+PalatinoLinotype TrueType WinAnsi yes yes no 207 0 KAEFIL+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 210 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-09-28 02:35:01 CEST RepresentationInformation: pmc_9141338.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-09-27 02:17:55 CEST Size: 1170373 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 314 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Definitions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Inclusion and Exclusion Criteria Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Info: Title: Effectiveness of Intermediate Respiratory Care Units as an Alternative to Intensive Care Units during the COVID-19 Pandemic in Catalonia Author: Marina Galdeano Lozano, Julio César Alfaro Álvarez, Núria Parra Macías, Rosario Salas Campos, Sarah Heili Frades, Josep Maria Montserrat, Antoni Rosell Gratacós, Jorge Abad Capa, Olga Parra Ordaz and Francesc López Seguí Subject: AbstractObjectives: During the COVID-19 pandemic, the risk of collapse for the health system created great difficulties. We will demonstrate that intermediate respiratory care units (IRCU) provide adequate management of patients with non-invasive respiratory support, which is particularly important for patients with SARS-CoV-2 pneumonia. Methods: A prospective observational study of patients with COVID-19 admitted to the ICU of a tertiary hospital. Sociodemographic data, comorbidities, pharmacological, respiratory support, laboratory and blood gas variables were collected. The overall cost of the unit was subsequently analyzed. Results: 991 patients were admitted, 56 to the IRCU (from a of 81 admitted to the critical care unit). Mean age was 65 years (SD 12.8), Barthel index 75 (SD 8.3), Charlson comorbidity index 3.1 (SD 2.2), HTN 27%, COPD 89% and obesity 24%. A significant relationship (p < 0.05) with higher mortality was noted for the following parameters: fever greater than or equal to 39 C [OR 5.6; 95% CI (1.2 2.7); p = 0.020], protocolized pharmacological treatment [OR 0.3; 95% CI (0.1 0.9); p = 0.023] and IOI [OR 3.7; 95% CI (1.1 12.3); p = 0.025]. NIMV had less of a negative impact [OR 1.8; 95% CI (0.4 8.4); p = 0.423] than IOI. The total cost of the IRCU amounted to €66,233. The cost per day of stay in the IRCU was €164 per patient. The total cost avoided was €214,865. Conclusions: The pandemic has highlighted the importance of IRCUs in facilitating the management of a high patient volume. The treatment carried out in IRCUs is effective and efficient, reducing both admissions to and stays in the ICU. 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