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BMC Medicine
Published in: BMC Medicine 1/2020

01-12-2020 | Triage | Research article

Allocation of intensive care resources during an infectious disease outbreak: a rapid review to inform practice

Authors: Kirsten M. Fiest, Karla D. Krewulak, Kara M. Plotnikoff, Laryssa G. Kemp, Ken Kuljit S. Parhar, Daniel J. Niven, John B. Kortbeek, Henry T. Stelfox, Jeanna Parsons Leigh

Published in: BMC Medicine | Issue 1/2020

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Abstract

Background

The COVID-19 pandemic has placed sustained demand on health systems globally, and the capacity to provide critical care has been overwhelmed in some jurisdictions. It is unknown which triage criteria for allocation of resources perform best to inform health system decision-making. We sought to summarize and describe existing triage tools and ethical frameworks to aid healthcare decision-making during infectious disease outbreaks.

Methods

We conducted a rapid review of triage criteria and ethical frameworks for the allocation of critical care resources during epidemics and pandemics. We searched Medline, EMBASE, and SCOPUS from inception to November 3, 2020. Full-text screening and data abstraction were conducted independently and in duplicate by three reviewers. Articles were included if they were primary research, an adult critical care setting, and the framework described was related to an infectious disease outbreak. We summarized each triage tool and ethical guidelines or framework including their elements and operating characteristics using descriptive statistics. We assessed the quality of each article with applicable checklists tailored to each study design.

Results

From 11,539 unique citations, 697 full-text articles were reviewed and 83 articles were included. Fifty-nine described critical care triage protocols and 25 described ethical frameworks. Of these, four articles described both a protocol and ethical framework. Sixty articles described 52 unique triage criteria (29 algorithm-based, 23 point-based). Few algorithmic- or point-based triage protocols were good predictors of mortality with AUCs ranging from 0.51 (PMEWS) to 0.85 (admitting SOFA > 11). Most published triage protocols included the substantive values of duty to provide care, equity, stewardship and trust, and the procedural value of reason.

Conclusions

This review summarizes available triage protocols and ethical guidelines to provide decision-makers with data to help select and tailor triage tools. Given the uncertainty about how the COVID-19 pandemic will progress and any future pandemics, jurisdictions should prepare by selecting and adapting a triage tool that works best for their circumstances.
Appendix
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Literature
1.
2.
3.
4.
5.
Herold S, Becker C, Ridge KM, Budinger GR. Influenza virus-induced lung injury: pathogenesis and implications for treatment. Eur Respir J. 2015;45(5):1463–78.PubMedCrossRef
6.
Marshall JC, Bosco, L., Adhikari, N. K., Connolly, B., Diaz, J. V., Dorman, T., Fowler, R. A., Meyfroidt, G., Nakagawa, S., Pelosi, P., Vincent, J. L., Vollman, K., & Zimmerman, J. What is an intensive care unit? A report of the task force of the World Federation of Societies of Intensive and Critical Care Medicine. J Critical Care. 2017;37:270–6.
7.
8.
9.
News W. World is ill-prepared for “inevitable” flu pandemic. Bull World Health Organ. 2004;82(4):317–8.
10.
Emanuel EJ, Persad G, Upshur R, Thome B, Parker M, Glickman A, et al. Fair allocation of scarce medical resources in the time of COVID-19. N Engl J Med. 2020;382(21):2049–55.
11.
Christian MD, Sprung CL, King MA, Dichter JR, Kissoon N, Devereaux AV, et al. Triage: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest. 2014;146(4 Suppl):e61S–74S.PubMedCrossRef
12.
Maves RC, Downar J, Dichter JR, Hick JL, Devereaux A, Geiling JA, et al. Triage of scarce critical care resources in COVID-19 an implementation guide for regional allocation: an expert panel report of the Task Force for Mass Critical Care and the American College of Chest Physicians. Chest. 2020;158(1):212–25.PubMedCrossRef
13.
Dahine J, Hébert PC, Ziegler D, Chenail N, Ferrari N, Hébert R. Practices in triage and transfer of critically ill patients: a qualitative systematic review of selection criteria. Crit Care Med. 2020.
14.
Leider JP, DeBruin D, Reynolds N, Koch A, Seaberg J. Ethical guidance for disaster response, specifically around crisis standards of care: a systematic review. Am J Public Health. 2017;107(9):e1–9.PubMedPubMedCentralCrossRef
15.
Antommaria AHM, Gibb TS, McGuire AL, Wolpe PR, Wynia MK, Applewhite MK, et al. Ventilator triage policies during the COVID-19 pandemic at U.S. hospitals associated with members of the association of bioethics program directors. Ann Intern Med. 2020;173(3):188-194.
16.
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.PubMedPubMedCentralCrossRef
17.
Moola S MZ, Tufanaru C, Aromataris E, Sears K, Sfetcu R, Currie M, Qureshi R, Mattis P, Lisy K, Mu P-F. Chapter 7: Systematic reviews of etiology and risk. In: Aromataris E MZ, editor. Joanna Briggs Institute Reviewer’s Manual: The Joanna Briggs Institute; 2017.
18.
Lockwood CMZ, Porritt K. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation. Int J Evidence Based Healthcare. 2015;13(3):179–87.CrossRef
19.
McArthur AKJ, Yan H, Florescu S. Innovations in the systematic review of text and opinion. Int J Evid Evide Based Healthc. 2015;13(3):188–95.CrossRef
20.
Tufanaru C MZ, Aromataris E, Campbell J, Hopp L. Chapter 3: Systematic reviews of effectiveness. . In: Aromataris E MZ, editor. Joanna Briggs Institute Reviewer’s Manual: The Joanna Briggs Institute; 2017.
21.
Whiting PF RA, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, Leeflang MM, Sterne JA, Bossuyt PM, QUADAS-2 Group. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011;155(8):529–536.
22.
Campbell JMKM, Ding S, Carmody DP, Hakonsen SJ, Jadotte YT, White S, Munn Z. Diagnostic test accuracy: methods for systematic review and meta-analysis. Int J Evidence Based Healthcare. 2015;13(3):154–62.CrossRef
23.
Lin JY, Anderson-Shaw L. Rationing of resources: ethical issues in disasters and epidemic situations. Prehosp Disasted Med. 2009;24(3):215–21.CrossRef
24.
Powell T, Christ KC, Birkhead GS. Allocation of ventilators in a public health disaster. Disaster Med Public Health Prep. 2008;2(1):20–6.PubMedCrossRef
25.
Prekker ME, Brunsvold ME, Bohman JK, Fischer G, Gram KL, Litell JM, et al. Regional planning for extracorporeal membrane oxygenation allocation during COVID-19. Chest. 2020.
26.
Utley M, Pagel C, Peters MJ, Petros A, Lister P. Does triage to critical care during a pandemic necessarily result in more survivors? Crit Care Med. 2011;39(1):179–83.PubMedCrossRef
27.
Kanter RK. Would triage predictors perform better than first-come, first-served in pandemic ventilator allocation? Chest. 2015;147(1):102–8.PubMedCrossRef
28.
Christian MD, Hawryluck L, Wax RS, Cook T, Lazar NM, Herridge MS, et al. Development of a triage protocol for critical care during an influenza pandemic. CMAJ. 2006;175(11):1377–81.PubMedPubMedCentralCrossRef
29.
Valiani S, Terrett L, Gebhardt C, Prokopchuk-Gauk O, Isinger M. Development of a framework for critical care resource allocation for the COVID-19 pandemic in Saskatchewan. CMAJ. 2020;192(37):E1067–E73.PubMedPubMedCentralCrossRef
30.
Janig C, Forklage R, Gurney JM, Groth R, Wirth C, van de Krol H, et al. Triage decisions in the context of COVID-19: old burden, new challenge-the Structured Approach for Intensive Care Unit Triage (SAINT) protocol. Mil Med. 2020;02:02.
31.
Ehmann MR, Zink EK, Levin AB, Suarez JI, Belcher HM, Daugherty Biddison EL, et al. Operational recommendations for scarce resource allocation in a public health crisis. Chest. 2020;26:26.
32.
Real de Asua D, Galvan JM, Iglesias J, Fernandez J, Maria Galvan J, Diego R, et al. Triage criteria for cardiopulmonary resuscitation and advanced life support during the COVID-19 epidemic. Med Clin (Barc). 2020;155(5):215–9.PubMedCentralCrossRef
33.
Sprung CL, Joynt GM, Christian MD, Truog RD, Rello J, Nates JL. Adult ICU triage during the coronavirus disease 2019 pandemic: who will live and who will die? Recommendations to Improve Survival. Crit Care Med. 2020;48(8):1196–1202.
34.
Kaposy C, Bandrauk N, Pullman D, Singleton R, Brunger F. Adapting the Hamilton Health Sciences critical care pandemic triage protocol. Healthc Q. 2010;13(2):60–3.PubMedCrossRef
35.
Han SA, Koch VG. Clinical and Ethical Considerations in Allocation of Ventilators in an Influenza Pandemic or Other Public Health Disaster: A Comparison of the 2007 and. New York State Ventilator Allocation Guidelines. Disaster Med Public Health Prep. 2015;2020:1–27.
36.
Frolic A, Kata A, Kraus P. Development of a critical care triage protocol for pandemic influenza: integrating ethics, evidence and effectiveness. Healthc Q. 2009;12(4):54–62.PubMedCrossRef
37.
Warrillow S, Austin D, Cheung W, Close E, Holley A, Horgan B, et al. ANZICS guiding principles for complex decision making during the COVID-19 pandemic. Crit Care Resusc. 2020;22(2):98–102.PubMed
38.
Sprung CL, Zimmerman JL, Christian MD, Joynt GM, Hick JL, Taylor B, et al. Recommendations for intensive care unit and hospital preparations for an influenza epidemic or mass disaster: summary report of the European Society of Intensive Care Medicine’s Task Force for intensive care unit triage during an influenza epidemic or mass disaster. Intensive Care Med. 2010;36(3):428–43.PubMedPubMedCentralCrossRef
39.
Cheung WK, Myburgh J, Seppelt IM, Parr MJ, Blackwell N, Demonte S, et al. A multicentre evaluation of two intensive care unit triage protocols for use in an influenza pandemic. Med J Aust. 2012;197(3):178–81.PubMedCrossRef
40.
Ashton-Cleary D, Tillyard A, Freeman N. Intensive care admission triage during a pandemic: a survey of the acceptability of triage tools. J Intensive Care Soc. 2011;12(3):180–6.CrossRef
41.
Marriott D, Turner Z, Robin N, Singh S. To admit or not to admit? The suitability of critical care admission criteria. Crit Care. 2012;Conference:32nd International Symposium on Intensive Care and Emergency Medicine. Brussels Belgium. Conference Publication: (var.pagings). 16 (SUPPL. 1) (pp S181-S2).
42.
Leclerc T, Donat N, Donat A, Pasquier P, Libert N, Schaeffer E, et al. Prioritisation of ICU treatments for critically ill patients in a COVID-19 pandemic with scarce resources. Anaesth Crit Care Pain Med. 2020;39(3):333–9.PubMedPubMedCentralCrossRef
43.
Hick JL, O’Laughlin DT. Concept of operations for triage of mechanical ventilation in an epidemic. Acad Emerg Med. 2006;13(2):223–9.PubMedCrossRef
44.
Azoulay É, Beloucif S, Guidet B, Pateron D, Vivien B, Le Dorze M. Admission decisions to intensive care units in the context of the major COVID-19 outbreak: local guidance from the COVID-19 Paris-region area. Crit Care. 2020;24(1):293.PubMedPubMedCentralCrossRef
45.
Herreros B, Gella P, Real de Asua D. Triage during the COVID-19 epidemic in Spain: better and worse ethical arguments. J Med Ethics 2020;46(7):455–458.
46.
Marckmann G, Neitzke G, Schildmann J, Michalsen A, Dutzmann J, Hartog C, et al. Decisions on the allocation of intensive care resources in the context of the COVID-19 pandemic : clinical and ethical recommendations of DIVI, DGINA, DGAI, DGIIN, DGNI, DGP, DGP and AEM. Med Klin Intensivmed Notfmed 2020;29:29.
47.
Committee PCPE. Interim ethical recommendations in medical management in the COVID-19 crisis. Philipp J Intern Med. 2020;58(1):VIII-XIV.
48.
Cheung W, Myburgh J, Seppelt IM, Parr MJ, Blackwell N, Demonte S, et al. Development and evaluation of an influenza pandemic intensive care unit triage protocol. Crit Care Resusc. 2012;14(3):185–90.PubMed
49.
Swiss Academy of Medical Sciences. COVID-19 pandemic: triage for intensive-care treatment under resource scarcity. Swiss Med Wkly. 2020;150:w20229.
50.
Vincent JL, 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.PubMedCrossRef
51.
Gupta S, Batt J, Bourbeau J, Chapman KR, Gershon A, Granton J, et al. Triaging access to critical care resources in patients with chronic respiratory diseases in the event of a major COVID-19 surge: key highlights from the Canadian Thoracic Society (CTS) Position Statement. Chest. 2020;18:18.
52.
Montgomery J, Stokes-Lampard HJ, Griffiths MD, Gardiner D, Harvey D, Suntharalingam G. Assessing whether COVID-19 patients will benefit from critical care, and an objective approach to capacity challenges during a pandemic: an Intensive Care Society clinical guideline. J Intensive Care Soc. 2020; https://​doi.​org/​10.​1177/​1751143720948537​.
53.
Vergano M, Bertolini G, Giannini A, Gristina GR, Livigni S, Mistraletti G, et al. SIAARTI recommendations for the allocation of intensive care treatments in exceptional, resource-limited circumstances. Minerva Anestesiol. 2020;86(5):469–72.PubMedCrossRef
54.
Murad H, Kaufman D, Greenlaw J, Harvey T, D’Angio C, Demme R. Assessment of the new york state department of health proposed guidelines for ventilator allocation in the scenario of severe influenza pandemic. Crit Care Med. 2009;Conference:39th Critical Care Congress of the Society of Critical Care Medicine’s. Miami Beach, FL United States. Conference Publication: (var.pagings). 7 (12 SUPPL.) (pp A387).
55.
Rowan KM, Harrison DA, Walsh TS, McAuley DF, Perkins GD, Taylor BL, et al. The Swine Flu Triage (SwiFT) study: development and ongoing refinement of a triage tool to provide regular information to guide immediate policy and practice for the use of critical care services during the H1N1 swine influenza pandemic. Health Technol Assess Rep. 2011;14(55):335–492.
56.
Wilkens EP, Klein GM. Mechanical ventilation in disaster situations: a new paradigm using the AGILITIES Score System. Am J Disaster Med. 2010;5(6):369–84.PubMedCrossRef
57.
Myles PR, Nguyen-Van-Tam JS, Lim WS, Nicholson KG, Brett SJ, Enstone JE, et al. Comparison of CATs, CURB-65 and PMEWS as triage tools in pandemic influenza admissions to UK hospitals: case control analysis using retrospective data. PLoS ONE. 2012;7(4):e34428.
58.
Daugherty Biddison EL, Faden R, Gwon HS, Mareiniss DP, Regenberg AC, Schoch-Spana M, et al. Too many patients...a framework to guide statewide allocation of scarce mechanical ventilation during disasters. Chest. 2019;155(4):848–854.
59.
Challen K, Bright J, Bentley A, Walter D. Physiological-social score (PMEWS) vs. CURB-65 to triage pandemic influenza: a comparative validation study using community-acquired pneumonia as a proxy. BMC Health Serv Res. 2007;7(no pagination).
60.
Muller MP, McGeer AJ, Hassan K, Marshall J, Christian M, Toronto Invasive Bacterial Disease N. Evaluation of pneumonia severity and acute physiology scores to predict ICU admission and mortality in patients hospitalized for influenza. PLoS ONE. 2010;5(3):e9563.
61.
Adeniji KA, Cusack R. The Simple Triage Scoring System (STSS) successfully predicts mortality and critical care resource utilization in H1N1 pandemic flu: a retrospective analysis. Crit Care. 2011;15(1):R39.
62.
Talmor D, Jones AE, Rubinson L, Howell MD, Shapiro NI. Simple triage scoring system predicting death and the need for critical care resources for use during epidemics. Crit Care Med. 2007;35(5):1251–6.PubMedCrossRef
63.
Morton B, Tang L, Gale R, Kelly M, Robertson H, Mogk M, et al. Performance of influenza-specific triage tools in an H1N1-positive cohort: P/F ratio better predicts the need for mechanical ventilation and critical care admission. Br J Anaesth. 2015;114(6):927–33.PubMedCrossRef
64.
Morton B, Tang L, Gale R, Kelly M, Robertson H, Williams K, et al. Do pandemic influenza specific triaging tools perform better than conventional severity scores? A retrospective cohort study. Intensive Care Med. 2014;Conference:27th Annual Congress of the European Society of Intensive Care Medicine, ESICM 2014. Barcelona Spain. Conference Publication: (var.pagings). 40 (1 SUPPL. 1) (pp S65).
65.
Ibrahim H, Sorrell S, Nair SC, Al Romaithi A, Al Mazrouei S, Kamour A. Rapid development and utilization of a clinical intelligence dashboard for frontline clinicians to optimize critical resources during COVID-19. Acta Informatica Medica. 2020;28(3):209–13.CrossRefPubMedPubMedCentral
66.
Ryan L, Lam C, Mataraso S, Allen A, Green-Saxena A, Pellegrini E, et al. Mortality prediction model for the triage of COVID-19, pneumonia, and mechanically ventilated ICU patients: a retrospective study. Ann Med. 2020;59:207–16.
67.
Commons RJ, Denholm J. Triaging pandemic flu: pneumonia severity scores are not the answer. Int J Tuberc Lung Dis. 2012;16(5):670–3.PubMedCrossRef
68.
Estella A. Usefulness of CURB-65 and pneumonia severity index for influenza a H1N1v pneumonia. Monaldi Arch Chest Dis. 2012;77(3–4):118–21.PubMed
69.
Pereira JM, Moreno RP, Matos R, Rhodes A, Martin-Loeches I, Cecconi M, et al. Severity assessment tools in ICU patients with 2009 influenza A (H1N1) pneumonia. Clin Microbiol Infex. 2012;18(10):1040–8.CrossRef
70.
Enfield K, Miller R, Rice T, Thompson BT, Truwit J. Limited utility of SOFA and APACHE II prediction models for ICU triage in pandemic influenza. Chest. 2011;Conference:CHEST 2011. Honolulu, HI United States. Conference Publication: (var.pagings). 140 (4 MEETING ABSTRACT) (no pagination).
71.
Saleh A, Ahmed M, Abdel-Lateif A. Comparison of the mortality prediction of different ICU scoring systems (apache II and III, SAPS II, and sofa) in acute respiratory distress syndrome patients. Chest. 2016;Conference:CHEST World Congress 2016 Annual Meeting. Shanghai China. Conference Publication: (var.pagings). 149 (4 SUPPL. 1) A147.
72.
Grissom CK, Brown SM, Kuttler KG, Boltax JP, Jones J, Jephson AR, et al. A modified Sequential Organ Failure Assessment score for critical care triage. Disaster Med Public Health Prep. 2010;4(4):277–84.PubMedCrossRef
73.
Khan Z, Hulme J, Sherwood N. An assessment of the validity of SOFA score based triage in H1N1 critically ill patients during an influenza pandemic. Anaesthesia. 2009;64(12):1283–8.PubMedCrossRef
74.
Miller RR, Brown S, Enfield KB, Truwit JD, Dascomb KK, Jephson AR, et al. Overestimation of mortality by a SOFA-based influenza triage tool compared to intensive care unit mortality experienced during the early 2009 novel H1N1 influenza epidemic in Utah. Am J Respir Crit Care Med. 2010;Conference:American Thoracic Society International Conference, ATS 2010. New Orleans, LA United States. Conference Publication: (var.pagings). 181 (1 MeetingAbstracts) (no pagination).
75.
Shahpori R, Stelfox HT, Doig CJ, Boiteau PJE, Zygun DA. Sequential Organ Failure Assessment in H1N1 pandemic planning. Crit Care Med. 2011;39(4):827–32.PubMedCrossRef
76.
Williams L, Gannon J. Use of the SOFA score in pandemic influenza - a prospective study. J Intensive Care Soc. 2009;10(3):179–82.
77.
Adalja AA, Watson M, Waldhorn RE, Toner ES. A conceptual approach to improving care in pandemics and beyond: severe lung injury centers. J Crit Care. 2013;28(3):318.e9-15.
78.
Guest T, Tantam G, Donlin N, Tantam K, McMillan H, Tillyard A. An observational cohort study of triage for critical care provision during pandemic influenza: ‘clipboard physicians’ or ‘evidenced based medicine’? Anaesthesia. 2009;64(11):1199–206.PubMedCrossRef
79.
Christian MD, Hamielec C, Lazar NM, Wax RS, Griffith L, Herridge MS, et al. A retrospective cohort pilot study to evaluate a triage tool for use in a pandemic. Crit Care. 2009;13(5):R170.
80.
O’Laughlin DT, Hick JL. Ethical issues in resource triage. Respir Care. 2008;53(2):190–7 discussion 7-200.PubMed
81.
Farrell TW, Francis L, Brown T, Ferrante LE, Widera E, Rhodes R, et al. Rationing limited healthcare resources in the COVID-19 era and beyond: ethical considerations regarding older adults. J Am Geriatr Soc. 2020;68(6):1143–9.PubMedCrossRef
82.
Seethala R, Keller SP. Extracorporeal membrane oxygenation resource planning in the setting of pandemic respiratory illness. Ann Am Thorac Soc. 2020;17(7):800–3.PubMedPubMedCentralCrossRef
83.
Rhodes KV, Wei EK, Salway RJ, Natsui S, Silvestri D, Cassel CK. The New York City pandemic resuscitation equitable allocation principles. Resuscitation. 2020;156:123–4.PubMedPubMedCentralCrossRef
84.
Steinberg A, Levy-Lahad E, Karni T, Sprung CL. Israeli position paper: triage decisions for severely ill patients during the COVID-19 pandemic. Chest. 2020;158(6):2278–81.
85.
Christian MD, Joynt GM, Hick JL, Colvin J, Danis M, Sprung CL, et al. Chapter 7. Critical care triage. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster. Intensive Care Med. 2010;36 Suppl 1:S55–64.
86.
Cinti SK, Barnosky AR, Gay SE, Goold SD, Lozon MM, Kim K, et al. Bacterial pneumonias during an influenza pandemic: how will we allocate antibiotics? Biosecur Bioterror. 2009;7(3):311–6.PubMedCrossRef
87.
Daugherty Biddison EL, Gwon H, Schoch-Spana M, Cavalier R, White DB, Dawson T, et al. The community speaks: understanding ethical values in allocation of scarce lifesaving resources during disasters. Ann Am Thorac Soc. 2014;11(5):777–83.PubMedCrossRef
88.
Daugherty Biddison EL, Berkowitz KA, Courtney B, De Jong MJ, Devereaux AV, Kissoon N, et al. Ethical considerations: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest. 2014;146(Supplement 4):e145S–55S.
89.
Devereaux AV, Dichter JR, Christian MD, Dubler NN, Sandrock CE, Hick JL, et al. Definitive care for the critically III during a disaster: a framework for allocation of scarce resources in mass critical care. Chest. 2008;133(5 SUPPL):51S–66S.
90.
Eastman N, Philips B, Rhodes A. Triaging for adult critical care in the event of overwhelming need. Intensive Care Med. 2010;36(6):1076–82.PubMedCrossRef
91.
Einav S, Hick JL, Hanfling D, Erstad BL, Toner ES, Branson RD, et al. Surge capacity logistics: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest. 2014;146(4 Suppl):e17S–43S.PubMedCrossRef
92.
Rubinson L, Nuzzo JB, Talmor DS, O’Toole T, Kramer BR, Inglesby TV. Augmentation of hospital critical care capacity after bioterrorist attacks or epidemics: recommendations of the Working Group on Emergency Mass Critical Care. Crit Care Med. 2005;33(10):2393–403.PubMedCrossRef
93.
Silva DS, Gibson JL, Robertson A, Bensimon CM, Sahni S, Maunula L, et al. Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public’s perspectives. BMC Public Health. 2012;12:241.PubMedPubMedCentralCrossRef
94.
Cheung W, Myburgh J, McGuinness S, Chalmers D, Parke R, Blyth F, et al. A cross-sectional survey of Australian and New Zealand public opinion on methods to triage intensive care patients in an influenza pandemic. Critical Care Resuscitation. 2017;19(3):254–65.PubMed
95.
Cheung W, Myburgh J, McGuinness S, Chalmers D, Parke R, Blyth F, et al. A cross-sectional survey of Australian and New Zealand public opinion on methods to triage intensive care patients in an influenza pandemic. Crit Care Resusc. 2017;19(3):254–65.PubMed
96.
Dries D, Reed MJ, Kissoon N, Christian MD, Dichter JR, Devereaux AV, et al. Special populations: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest. 2014;146(4 Suppl):e75S–86S.PubMedCrossRef
97.
Tillyard A. Reorganising the pandemic triage processes to ethically maximise individuals’ best interests. Intensive Care Med. 2010;36(11):1966–71.PubMedCrossRef
98.
Daugherty Biddison ELD, Gwon HS, Schoch-Spana M, Regenberg AC, Juliano C, Faden RR, et al. Scarce resource allocation during disasters: a mixed-method community engagement study. Chest. 2018;153(1):187–95.CrossRef
99.
Tabery J, Mackett ICW. Ethics of triage in the event of an influenza pandemic. Disaster Med Public Health Prep. 2008;2(2):114–8.PubMedCrossRef
100.
Christian MD, Devereaux AV, Dichter JR, Rubinson L, Kissoon N, Task Force for Mass Critical C, et al. Introduction and executive summary: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest. 2014;146(4 Suppl):8S–34S.
101.
Ardagh M. Criteria for prioritising access to healthcare resources in New Zealand during an influenza pandemic or at other times of overwhelming demand. N Z Med J. 2006;119(1243):U2256.PubMed
102.
Shekar K, Badulak J, Peek G, Boeken U, Dalton HJ, Arora L, et al. Extracorporeal life support organization coronavirus disease 2019 interim guidelines: a consensus document from an international group of interdisciplinary extracorporeal membrane oxygenation providers. ASAIO J 2020;66(7):707–21.
103.
Winsor S, Bensimon CM, Sibbald R, Anstey K, Chidwick P, Coughlin K, et al. Identifying prioritization criteria to supplement critical care triage protocols for the allocation of ventilators during a pandemic influenza. Healthc Q. 2014;17(2):44–51.PubMedCrossRef
104.
Angus DC, Marrie TJ, Obrosky DS, Clermont G, Dremsizov TT, Coley C, et al. Severe community-acquired pneumonia: use of intensive care services and evaluation of American and British Thoracic Society Diagnostic criteria. Am J Respir Crit Care Med. 2002;166(5):717–23.PubMedCrossRef
105.
Jones AE, Trzeciak S, Kline JA. The Sequential Organ Failure Assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation. Crit Care Med. 2009;37(5):1649–54.PubMedPubMedCentralCrossRef
106.
Alvarez M, Nava JM, Rué M, Quintana S. Mortality prediction in head trauma patients: performance of Glasgow Coma Score and general severity systems. Crit Care Med. 1998;26(1):142–8.PubMedCrossRef
107.
Tambone V, Boudreau D, Ciccozzi M, Sanders K, Campanozzi LL, Wathuta J, et al. Ethical Criteria for the Admission and Management of Patients in the ICU Under Conditions of Limited Medical Resources: A Shared International Proposal in View of the COVID-19 Pandemic. Front Public Health. 2020;8:284.
108.
Schuetz P, Koller M, Christ-Crain M, Steyerberg E, Stolz D, Müller C, et al. Predicting mortality with pneumonia severity scores: importance of model recalibration to local settings. Epidemiol Infect. 2008;136(12):1628–37.PubMedPubMedCentralCrossRef
109.
Wynants L, Van Calster B, Bonten MMJ, Collins GS, Debray TPA, De Vos M, et al. Prediction models for diagnosis and prognosis of COVID-19 infection: systematic review and critical appraisal. BMJ. 2020;369:m1328.PubMedPubMedCentralCrossRef
110.
Ornelas J, Dichter JR, Devereaux AV, Kissoon N, Livinski A, Christian MD, et al. Methodology: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest. 2014;146(4 Suppl):35S–41S.PubMedCrossRef
111.
Ahmed I. COVID-19 – does exercise prescription and maximal oxygen uptake (VO2 max) have a role in risk-stratifying patients? J R Coll Physicians Lond. 2020;20(3):282–4.
112.
Baumrucker SJ, Carter G, Adkins RW, Perkins C, Stolick M, VandeKieft G. Ethics roundtable: distribution of critical care resources in the setting of a COVID-19 surge. Am J Hosp Palliat Care. 2020;37(12):1096–101.PubMedCrossRef
113.
Challen K, Goodacre SW, Wilson R, Bentley A, Campbell M, Fitzsimmons C, et al. Evaluation of triage methods used to select patients with suspected pandemic influenza for hospital admission. EMJ. 2011;17.
114.
Darvall JN, Bellomo R, Bailey M, Paul E, Young PJ, Rockwood K, et al. Frailty and outcomes from pneumonia in critical illness: a population-based cohort study. Br J Anaesth. 2020;125(5):730–8.PubMedCrossRef
115.
116.
Mejia-Vilet JM, Cordova-Sanchez BM, Fernandez-Camargo DA, Mendez-Perez RA, Morales-Buenrostro LE, Hernandez-Gilsoul T. A risk score to predict admission to the intensive care unit in patients with COVID-19: the ABC-GOALS score. Salud Publ Mex. 2020;10:10.
117.
Nicholson CJ, Wooster L, Sigurslid HH, Li RF, Jiang W, Tian W, et al. Estimating risk of mechanical ventilation and mortality among adult COVID-19 patients admitted to Mass General Brigham: the VICE and DICE scores. Medrxiv. 2020;16:16.
118.
Walsh B, Mukherjee V, Uppal A. An observational cohort study: how would resource allocation policies perform during a surge of patients with COVID-19? Chest. 2020;158(4 Supplement):A1173.CrossRef
119.
Wu G, Yang P, Xie Y, Woodruff HC, Rao X, Guiot J, et al. Development of a clinical decision support system for severity risk prediction and triage of COVID-19 patients at hospital admission: an international multicenter study. Eur Respir J. 2020;02:02.
120.
Moodley K, Ravez L, Obasa AE, Mwinga A, Jaoko W, Makindu D, et al. What could “fair allocation” during the COVID-19 crisis possibly mean in sub-Saharan Africa? Hast Cent Rep. 2020;50(3):33–5.CrossRef
121.
122.
Killien EY, Mills B, Errett NA, Sakata V, Vavilala MS, Rivara FP, Kissoon N, King MA. Prediction of pediatric critical care resource utilization for disaster triage. Pediatric Critical Care Med. 2020;21(8):e491–501.
123.
Kim KM, Cinti S, Gay S, Goold S, Barnosky A, Lozon M. Triage of mechanical ventilation for pediatric patients during a pandemic. Disaster Med Public Health Preparedness. 2012;6(2):131–1378.CrossRef
124.
Barie PS, Bronstein M, Gibson CJ, Kelly AG, Lee C, Narayan M, Shou J, Smith KE, Villegas C, Winchell RJ. A Simple Three-Tier Classification System for Triage, Communication, and Resource Utilization by Patients Afflicted with COVID-19 Disease. Surg Infect (Larchmt). 2020;21(8):726–7.
125.
Brandão-Neto RA, Goulart AC, Santana AN, Martins HS, Ribeiro SC, Ho LY, Chiamolera M, Magri MM, Scalabrini-Neto A, Velasco IT. The role of pneumonia scores in the emergency room in patients infected by 2009 H1N1 infection. Eur J Emerg Med. 2012;19(3):200–2.
Metadata
Title
Allocation of intensive care resources during an infectious disease outbreak: a rapid review to inform practice
Authors
Kirsten M. Fiest
Karla D. Krewulak
Kara M. Plotnikoff
Laryssa G. Kemp
Ken Kuljit S. Parhar
Daniel J. Niven
John B. Kortbeek
Henry T. Stelfox
Jeanna Parsons Leigh
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2020
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-020-01871-9

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