Clinical and organizational framework of repurposing pediatric intensive care unit to adult critical care in a resource-limited setting: Lessons from the response of an urban general hospital to the COVID-19 pandemic

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dc.contributor.authorDíaz, Franco
dc.contributor.authorKehr, Juan
dc.contributor.authorCores, Camila
dc.contributor.authorRubilar, Patricia
dc.contributor.authorMedina, Tania
dc.contributor.authorVargas, Caroline
dc.contributor.authorCruces, Pablo
dc.date.accessioned2022-12-03T13:09:50Z
dc.date.available2022-12-03T13:09:50Z
dc.date.issued2022
dc.description.abstractPurpose We aim to describe the action plan and clinical results of a COVID-19 unit for adult patient care in units intended for critically ill children, proposing a clinical/administrative framework. Methods We reviewed the preparedness of the PICU team before the surge of cases of COVID-19 and the organizational/administrative issues to increase critical beds in a six-bed PICU allocated to adult critical care in a government-funded general hospital in Latin America. We analyzed the prospectively collected administrative/clinical data of severe COVID-19 cases admitted to PICU during the peak of the first wave of the pandemic. Results We describe a 6-step preparedness plan: recruitment and education, admission criteria, children diversion, team hierarchy, and general and respiratory equipment. The 6-bed PICU was allocated to adult care for 20 weeks, progressively increasing capacity to a 23-bed dedicated COVID-19 unit managed by the PICU team. A six-block bed organizational units were implemented, and personnel increased from 40 to 125 healthcare workers in 24 h shifts. COVID-19 incidence in personnel was 0.5/1000 workdays. One hundred thirty-six patients were admitted, median age 59 (51,65) years old, 68% were male, and 63% had P/F ≤ 100. In addition, 48% received mechanical ventilation, the median length of stay was 7 (3,17), and in-hospital mortality was 15%. Conclusions We propose an organizational framework for the role of PICU in the hospital action plan to increase adult critical beds. The cohort of patients admitted to a PICU repurposed as a COVID-19 ICU had good outcomes. These data are valuable to plan coordinated actions of the healthcare system for future scenarios.en
dc.identifier.citationDíaz F, Kehr J, Cores C, Rubilar P, Medina T, Vargas C, Cruces P. Clinical and organizational framework of repurposing pediatric intensive care unit to adult critical care in a resource-limited setting: Lessons from the response of an urban general hospital to the COVID-19 pandemic. J Crit Care. 2022 Apr;68:59-65. doi: 10.1016/j.jcrc.2021.12.004. Epub 2021 Dec 15. PMID: 34922313es
dc.identifier.issn0883-9441
dc.identifier.orcid0000-0003-4763-074Xes
dc.identifier.orcidhttps://doi.org/10.1016/j.jcrc.2021.12.004
dc.identifier.urihttp://hdl.handle.net/20.500.12254/2623
dc.language.isoenes
dc.publisherElsevieres
dc.relation.ispartofseriesJournal of Critical Care;68 (2022)
dc.rightsAtribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/cl/
dc.subject.otherCOVID-19es
dc.subject.otherDisaster responsees
dc.subject.otherPICUes
dc.subject.otherARDSes
dc.titleClinical and organizational framework of repurposing pediatric intensive care unit to adult critical care in a resource-limited setting: Lessons from the response of an urban general hospital to the COVID-19 pandemices
dc.typeArtículoes
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