Background

The COVID-19 pandemic tested the capacity of intensive care units (ICU) to respond to a crisis and demonstrated their fragility. Unsurprisingly, higher than usual mortality rates, lengths of stay (LOS), and ICU-acquired complications occurred during the pandemic. However, worse outcomes were not universal nor constant across ICUs and significant variation in outcomes was reported, demonstrating that some ICUs could adequately manage the surge of COVID-19.

Methods

In the present editorial, we discuss the concept of a resilient Intensive Care Unit, including which metrics can be used to address the capacity to respond, sustain results and incorporate new practices that lead to improvement.

Results

We believe that a resiliency analysis adds a component of preparedness to the usual ICU performance evaluation and outcomes metrics to be used during the crisis and in regular times.

Conclusions

The COVID-19 pandemic demonstrated the need for a resilient health system. Although this concept has been discussed for health systems, it was not tested in intensive care. Future studies should evaluate this concept to improve ICU organization for standard and pandemic times.

中文翻译：

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弹性重症监护病房

背景

COVID-19 大流行测试了重症监护病房 (ICU) 应对危机的能力，并证明了它们的脆弱性。不出所料，在大流行期间发生了高于通常的死亡率、住院时间 (LOS) 和 ICU 获得性并发症。然而，更糟糕的结果在 ICU 中并不是普遍存在的，也不是恒定不变的，并且报告的结果存在显着差异，这表明一些 ICU 可以充分应对 COVID-19 的激增。

方法

在本社论中，我们讨论了有弹性的重症监护病房的概念，包括哪些指标可用于解决应对能力、维持结果以及纳入可带来改善的新实践。

结果

我们认为，在危机期间和常规时间使用的常规 ICU 绩效评估和结果指标中，弹性分析增加了准备工作的一部分。

结论

COVID-19 大流行表明需要有弹性的卫生系统。尽管这一概念已经在卫生系统中进行了讨论，但并未在重症监护中进行测试。未来的研究应评估这一概念，以改善标准和大流行时期的 ICU 组织。