One hundred questionnaires from repurposed hospitals: with what forces and means did we fight the «second wave» of COVID-19?
K. M. Lebedinskii, I. Zabolotskikh, M. Kirov, Protsenko Dn, N. Trembach, V. A. Semkichev, A. I. Volchenkova, G. Vasileva, V. Volchkov, A. Ovezov, M. Neymark, P. Dunts, S. V. Khomiakov, I. V. Balaev, Y. Orlov, I. S. Abazova, V. S. Gorokhovskii, A. Skopets, A. Shchegolev, A. Gritsan, V. Gorbachev, A. Belkin, A. V. Vlasenko, E. Grigoryev, M. Zamyatin, A. Kuzovlev, V. Kuzkov, V. V. Lazarev, R. E. Lakhin, V. V. Lomivorotov, Subbotin Vv, E. Shifman, A. Yaroshetskiy
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Abstract
In November-December 2020, the Federation of Anesthesiologists and Reanimatologists has conducted a survey of intensive care units (ICU) in 100 hospitals re-profiled for the treatment of COVID-19. There were regional (n=44), city (n=31), district (n=13), inter-district (n=8) and federal (n=4) hospitals from 27 constituent entities of the Russian Federation. Capacity of 59 hospitals was less than 300 beds, 23 hospitals — over 500 beds, 18 hospitals — 300—500 beds. The number of ICU beds exceeded 10% of repurposed beds in 35 hospitals, 5—10% of ICU beds — in 51 hospitals, less than 5% — in 14 hospitals. There were 6—12 patients per one physician in 68 ICUs, less than 6 patients — in 12 ICUs, over 12 patients — in 20 ICUs. Also, there were 3-6 patients per a nurse in 69 ICUs, less than 3 patients — in 2 ICUs, over 6 patients — in 29 ICUs. Over 70% of the repurposed beds were provided with a networked oxygen supply in 61 hospitals, 50—70% — in 25 hospitals, less than 50% — in 14 hospitals. Oxygen flow rate over 10 l/min was provided in 70 hospitals, 5—10 l/min — in 28 hospitals, less than 5 l/min — in 2 hospitals. Over 80% of ICU beds are equipped with ventilators in 78 hospitals, 50—80% — in 15 hospitals, less than 50% — in 7 hospitals. Less than 5% of ventilators have been out of order throughout the pandemic in 62 ICUs, 5—10% — in 20 departments, over 10% — in 18 ICUs. High-flow oxygen therapy was not available in 48 ICUs, ultrasound — in 10 ICUs. ECMO was available only in 17 ICUs. If we consider the pandemic as a model of health system response to non-standard global challenges, these data are essential for critical analysis despite small sample size. © 2021, Media Sphera Publishing Group. All rights reserved.
来自改造医院的100份问卷:我们用什么力量和手段抗击了COVID-19的“第二波”?
2020年11月至12月,麻醉师和复活学家联合会对100家医院的重症监护病房(ICU)进行了调查,重新分析了COVID-19的治疗情况。共有来自俄罗斯联邦27个组成实体的区域医院(44家)、城市医院(31家)、区医院(13家)、区际医院(8家)和联邦医院(4家)。59家医院床位不足300张,23家医院床位超过500张,18家医院床位300 - 500张。35家医院的ICU床位数量超过了重新利用床位的10%,51家医院的ICU床位数量超过了5-10%,14家医院的ICU床位数量低于5%。68个icu中每一名医生有6 - 12名患者,12个icu中少于6名患者,20个icu中超过12名患者。此外,69个icu中每个护士有3-6名患者,2个icu中少于3名患者,29个icu中超过6名患者。61家医院为70%以上的改换床位提供了联网供氧,25家医院为50-70%,14家医院为不到50%。氧流量大于10 l/min的有70家,5 ~ 10 l/min的有28家,小于5 l/min的有2家。78家医院中,超过80%的ICU病床配备了呼吸机,15家医院中有50-80%配备了呼吸机,7家医院中有不到50%配备了呼吸机。在整个大流行期间,62个icu中只有不到5%的呼吸机出现故障,20个icu中有5-10%出现故障,18个icu中有10%以上出现故障。48个icu无高流量氧疗,10个icu无超声。ECMO仅适用于17个icu。如果我们将此次大流行视为卫生系统应对非标准全球挑战的一个模型,尽管样本量很小,但这些数据对于批判性分析至关重要。©2021,Media Sphera出版集团。版权所有。
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