Skip to main content
Top
Published in: Critical Care 1/2020

Open Access 01-12-2020 | Triage | Viewpoint

Admission decisions to intensive care units in the context of the major COVID-19 outbreak: local guidance from the COVID-19 Paris-region area

Authors: Élie Azoulay, Sadek Beloucif, Bertrand Guidet, Dominique Pateron, Benoît Vivien, Matthieu Le Dorze

Published in: Critical Care | Issue 1/2020

Login to get access

Abstract

SARS-CoV-2 has caused a global pandemic unprecedented in size, spread, severity, and mortality. The influx of patients with severe or life-threatening disease means that in some cases, the available medical resources are not sufficient to meet the needs of all patients. Hence, healthcare providers may be forced to make difficult choices about which patients should be referred to the ICU. This document is intended to provide conceptual support to all healthcare teams currently engaged in the frontline management of the COVID-19 pandemic. It aims to assist physicians in the decision-making process for ICU admission and to help them provide uninterrupted and high-quality care.
Literature
1.
go back to reference Medicine SSOIC. Recommendations for the admission of patients with COVID-19 to intensive care and intermediate care units (ICUs and IMCUs). Swiss Med Wkly. 2020;150:w20227. Medicine SSOIC. Recommendations for the admission of patients with COVID-19 to intensive care and intermediate care units (ICUs and IMCUs). Swiss Med Wkly. 2020;150:w20227.
2.
go back to reference Vincent J-L, Creteur J. Ethical aspects of the COVID-19 crisis: how to deal with an overwhelming shortage of acute beds. Eur Heart J Acute Cardiovasc Care 2020;9(3):248–52. Vincent J-L, Creteur J. Ethical aspects of the COVID-19 crisis: how to deal with an overwhelming shortage of acute beds. Eur Heart J Acute Cardiovasc Care 2020;9(3):248–52.
3.
go back to reference Kirkpatrick JN, Hull SC, Fedson S, Mullen B, Goodlin SJ. Allocating scarce resources and triaging patients during the COVID-19 pandemic. J Am Coll Cardiol. 2020;S0735-1097(20):35223–2. Kirkpatrick JN, Hull SC, Fedson S, Mullen B, Goodlin SJ. Allocating scarce resources and triaging patients during the COVID-19 pandemic. J Am Coll Cardiol. 2020;S0735-1097(20):35223–2.
4.
go back to reference Vergano M, Bertolini G, Giannini A, et al. Clinical ethics recommendations for the allocation of intensive care treatments in exceptional, resource-limited circumstances: the Italian perspective during the COVID-19 epidemic. Crit Care Lond Engl. 2020;24(1):165.CrossRef Vergano M, Bertolini G, Giannini A, et al. Clinical ethics recommendations for the allocation of intensive care treatments in exceptional, resource-limited circumstances: the Italian perspective during the COVID-19 epidemic. Crit Care Lond Engl. 2020;24(1):165.CrossRef
5.
go back to reference Joebges S, Biller-Andorno N. Ethics guidelines on COVID-19 triage-an emerging international consensus. Crit Care Lond Engl. 2020;24(1):201.CrossRef Joebges S, Biller-Andorno N. Ethics guidelines on COVID-19 triage-an emerging international consensus. Crit Care Lond Engl. 2020;24(1):201.CrossRef
6.
go back to reference 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(21):2049–55. 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(21):2049–55.
7.
go back to reference Alhazzani W, Møller MH, Arabi YM, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med. 2020:1–34. Alhazzani W, Møller MH, Arabi YM, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med. 2020:1–34.
8.
go back to reference Truog RD, Mitchell C, Daley G. The toughest triage — allocating ventilators in a pandemic. 2020;382(21):1973–75. Truog RD, Mitchell C, Daley G. The toughest triage — allocating ventilators in a pandemic. 2020;382(21):1973–75.
9.
go back to reference Phua J, Weng L, Ling L, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med. 2020;8(5):506–17. Phua J, Weng L, Ling L, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med. 2020;8(5):506–17.
10.
go back to reference Pochard F, Grassin M, Azoulay E. Ethical principles for everyone. Ann Intern Med. 2001;134(12):1152 author reply 1152-1153.CrossRef Pochard F, Grassin M, Azoulay E. Ethical principles for everyone. Ann Intern Med. 2001;134(12):1152 author reply 1152-1153.CrossRef
11.
go back to reference White DB, Braddock CH, Bereknyei S, Curtis JR. Toward shared decision making at the end of life in intensive care units: opportunities for improvement. Arch Intern Med. 2007;167(5):461–7.CrossRef White DB, Braddock CH, Bereknyei S, Curtis JR. Toward shared decision making at the end of life in intensive care units: opportunities for improvement. Arch Intern Med. 2007;167(5):461–7.CrossRef
12.
go back to reference Le Maguet P, Roquilly A, Lasocki S, et al. Prevalence and impact of frailty on mortality in elderly ICU patients: a prospective, multicenter, observational study. Intensive Care Med. 2014;40(5):674–82.PubMed Le Maguet P, Roquilly A, Lasocki S, et al. Prevalence and impact of frailty on mortality in elderly ICU patients: a prospective, multicenter, observational study. Intensive Care Med. 2014;40(5):674–82.PubMed
13.
go back to reference Radovanovic D, Rizzi M, Pini S, Saad M, Chiumello DA, Santus P. Helmet CPAP to treat acute hypoxemic respiratory failure in patients with COVID-19: a management strategy proposal. J Clin Med. 2020;9(4):1191. Radovanovic D, Rizzi M, Pini S, Saad M, Chiumello DA, Santus P. Helmet CPAP to treat acute hypoxemic respiratory failure in patients with COVID-19: a management strategy proposal. J Clin Med. 2020;9(4):1191.
14.
go back to reference Li J, Fink JB, Ehrmann S. High-flow nasal cannula for COVID-19 patients: low risk of bio-aerosol dispersion. Eur Respir J. 2020;55(5):2000892. Li J, Fink JB, Ehrmann S. High-flow nasal cannula for COVID-19 patients: low risk of bio-aerosol dispersion. Eur Respir J. 2020;55(5):2000892.
15.
16.
go back to reference Davies A, Hayes J. Palliative care in the context of a pandemic: similar but different. Clin Med (Lond). 2020. p. 2020–0157. Davies A, Hayes J. Palliative care in the context of a pandemic: similar but different. Clin Med (Lond). 2020. p. 2020–0157.
Metadata
Title
Admission decisions to intensive care units in the context of the major COVID-19 outbreak: local guidance from the COVID-19 Paris-region area
Authors
Élie Azoulay
Sadek Beloucif
Bertrand Guidet
Dominique Pateron
Benoît Vivien
Matthieu Le Dorze
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2020
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-020-03021-2

Other articles of this Issue 1/2020

Critical Care 1/2020 Go to the issue